Title

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)

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

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