Chronicity of Preoperative Opioid Usage Predicts Patient Satisfaction, Return to Work, and Achieving ODI MCID up to Two Years After Lumbar Fusion: Analysis from the Michigan Spine Surgery Improvement Collaborative (MSSIC)
Recommended Citation
Zakaria HM, Bazydlo MS, Schultz LR, Khalil JG, Schwalb JM, Park P, and Chang V. Chronicity of Preoperative Opioid Usage Predicts Patient Satisfaction, Return to Work, and Achieving ODI MCID up to Two Years After Lumbar Fusion: Analysis from the Michigan Spine Surgery Improvement Collaborative (MSSIC). Spine J 2019; 19(9):S85-S86.
Document Type
Conference Proceeding
Publication Date
8-2019
Publication Title
Spine J
Abstract
BACKGROUND CONTEXT: With the rampant opioid crises, it is important to evaluate the association of preoperative opioids and outcomes after lumbar spine surgery. PURPOSE: We sought to identify the relationship between preoperative opioid usage and patient satisfaction, return to work, and achieving ODI MCID up to two years after lumbar fusion. STUDY DESIGN/SETTING: Prospective cohort. PATIENT SAMPLE: The Michigan Spine Surgery Improvement Collaborative (MSSIC) is a prospective multicenter quality improvement collaborative. Currently there are more than 26 different hospitals involved, and more than 20,000 patients receiving surgery from both neurosurgeons and orthopedic spine surgeons. OUTCOME MEASURES: Patient satisfaction, return to work, and achieving ODI MCID up to two years after lumbar fusion. METHODS: Multivariate logistic regression models were constructed; variables tested include age, gender, race, PMH, and number of surgical levels. Preoperative opioid chronicity was defined as opioid naïve (no opioid usage), new opioid users (<6 wks), recent opioid users (6 wks– 3 mos), frequent opioid users (3 mos–6 mos), and chronic opioid users (>6 mos). Comparisons were done to opioid naïve patients. Patient satisfaction was measured by the NASS patient satisfaction index. RESULTS: A total of 8,693 lumbar fusion patients were analyzed. Chronic opioid users were less likely to be satisfied with their procedure at 90 days (OR 0.95, p<0.001), 1 year (OR 0.90, p<0.001), and 2 years (OR 0.87, p<0.001) after surgery. New opioid users were more likely to achieve ODI MCID at 90 days (OR 1.25, p<0.001), 1 year (OR 1.15, p<0.001), and 2 years (OR 1.22, p<0.002) postoperatively. Recent opioid users were more likely to achieve ODI MCID at 2 years (OR 1.26, p<0.001). Chronic opioid users were less likely to achieve ODI MCID at 90 days (OR 0.89, p<0.001), 1 year (OR 0.87, p=0.002), and 2 years (OR 0.82, p=0.004). Chronic opioid users were also less likely to return to work at 90 days (OR 0.83, p<0.001). CONCLUSIONS: Using the MSSIC database, we sought to identify the relationship between preoperative opioid usage and patient satisfaction, return to work, and achieving ODI MCID up to 2 years after lumbar fusion. FDA DEVICE/DRUG STATUS: This abstract does not discuss or include any applicable devices or drugs.
Volume
19
Issue
9
First Page
S85
Last Page
S86
