Increased preoperative narcotic use and its association with postoperative complications and length of hospital stay in patients undergoing spine surgery

Sheyan J. Armaghani, Dennis S. Lee, Jesse E. Bible, David N. Shau, Harrison Kay, Chi Zhang, Matthew J. Mcgirt, Clinton J. Devin

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33 Citations (Scopus)

Abstract

Study Design: Prospective cohort analysis. Objective: To assess the effect of preoperative narcotic use on the incidence of 30- and 90-day postoperative complications, as well as length of hospital stay (LOS) in patients undergoing spine surgery. Summary of Background Data: Previous work has associated an increased incidence of complications and length of stay following surgery in patients with increased preoperative narcotic use. Despite this and recent national attention highlighting the negative effects of narcotics, they remain commonly used for the management of pain in patients undergoing spine surgery. Materials And Methods: A total of 583 patients undergoing spine surgery for a structural lesion were evaluated. Self-reported preoperative narcotic consumption was obtained and converted to morphine equivalents at the initial preoperative visit. LOS was recorded upon discharge and presence/type of a postoperative complication within 30/90 days was obtained. A multivariable logistic and linear regression analysis was performed for the incidence of complications and length of stay controlling for clinically important covariates. Results: Narcotic use was not associated with 30- or 90-day complications; however, smoking status was significantly associated with 30-day complications. Increased preoperative narcotic use was significantly associated with increased LOS, as was age, type of surgery, and depression. Conclusions: Increased preoperative narcotic use and depression are associated with increased LOS in patients undergoing spine surgery. We calculated that for every 100 morphine equivalents a patient is taking preoperatively; their stay is extended 1.1 days. Narcotic use was not associated with 30- or 90-day postoperative complications. As reimbursement is bundled before surgery, providing interventions for patients with treatable causes for increased length of stay can save cost overall.

Original languageEnglish (US)
Pages (from-to)E93-E98
JournalJournal of Spinal Disorders and Techniques
Volume29
Issue number2
DOIs
StatePublished - Jan 1 2016

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Narcotics
Length of Stay
Spine
Morphine
Incidence
Depression
Pain Management
Linear Models
Cohort Studies
Logistic Models
Smoking
Regression Analysis
Prospective Studies
Costs and Cost Analysis

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Armaghani, Sheyan J. ; Lee, Dennis S. ; Bible, Jesse E. ; Shau, David N. ; Kay, Harrison ; Zhang, Chi ; Mcgirt, Matthew J. ; Devin, Clinton J. / Increased preoperative narcotic use and its association with postoperative complications and length of hospital stay in patients undergoing spine surgery. In: Journal of Spinal Disorders and Techniques. 2016 ; Vol. 29, No. 2. pp. E93-E98.
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abstract = "Study Design: Prospective cohort analysis. Objective: To assess the effect of preoperative narcotic use on the incidence of 30- and 90-day postoperative complications, as well as length of hospital stay (LOS) in patients undergoing spine surgery. Summary of Background Data: Previous work has associated an increased incidence of complications and length of stay following surgery in patients with increased preoperative narcotic use. Despite this and recent national attention highlighting the negative effects of narcotics, they remain commonly used for the management of pain in patients undergoing spine surgery. Materials And Methods: A total of 583 patients undergoing spine surgery for a structural lesion were evaluated. Self-reported preoperative narcotic consumption was obtained and converted to morphine equivalents at the initial preoperative visit. LOS was recorded upon discharge and presence/type of a postoperative complication within 30/90 days was obtained. A multivariable logistic and linear regression analysis was performed for the incidence of complications and length of stay controlling for clinically important covariates. Results: Narcotic use was not associated with 30- or 90-day complications; however, smoking status was significantly associated with 30-day complications. Increased preoperative narcotic use was significantly associated with increased LOS, as was age, type of surgery, and depression. Conclusions: Increased preoperative narcotic use and depression are associated with increased LOS in patients undergoing spine surgery. We calculated that for every 100 morphine equivalents a patient is taking preoperatively; their stay is extended 1.1 days. Narcotic use was not associated with 30- or 90-day postoperative complications. As reimbursement is bundled before surgery, providing interventions for patients with treatable causes for increased length of stay can save cost overall.",
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Increased preoperative narcotic use and its association with postoperative complications and length of hospital stay in patients undergoing spine surgery. / Armaghani, Sheyan J.; Lee, Dennis S.; Bible, Jesse E.; Shau, David N.; Kay, Harrison; Zhang, Chi; Mcgirt, Matthew J.; Devin, Clinton J.

In: Journal of Spinal Disorders and Techniques, Vol. 29, No. 2, 01.01.2016, p. E93-E98.

Research output: Contribution to journalArticle

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AU - Armaghani, Sheyan J.

AU - Lee, Dennis S.

AU - Bible, Jesse E.

AU - Shau, David N.

AU - Kay, Harrison

AU - Zhang, Chi

AU - Mcgirt, Matthew J.

AU - Devin, Clinton J.

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N2 - Study Design: Prospective cohort analysis. Objective: To assess the effect of preoperative narcotic use on the incidence of 30- and 90-day postoperative complications, as well as length of hospital stay (LOS) in patients undergoing spine surgery. Summary of Background Data: Previous work has associated an increased incidence of complications and length of stay following surgery in patients with increased preoperative narcotic use. Despite this and recent national attention highlighting the negative effects of narcotics, they remain commonly used for the management of pain in patients undergoing spine surgery. Materials And Methods: A total of 583 patients undergoing spine surgery for a structural lesion were evaluated. Self-reported preoperative narcotic consumption was obtained and converted to morphine equivalents at the initial preoperative visit. LOS was recorded upon discharge and presence/type of a postoperative complication within 30/90 days was obtained. A multivariable logistic and linear regression analysis was performed for the incidence of complications and length of stay controlling for clinically important covariates. Results: Narcotic use was not associated with 30- or 90-day complications; however, smoking status was significantly associated with 30-day complications. Increased preoperative narcotic use was significantly associated with increased LOS, as was age, type of surgery, and depression. Conclusions: Increased preoperative narcotic use and depression are associated with increased LOS in patients undergoing spine surgery. We calculated that for every 100 morphine equivalents a patient is taking preoperatively; their stay is extended 1.1 days. Narcotic use was not associated with 30- or 90-day postoperative complications. As reimbursement is bundled before surgery, providing interventions for patients with treatable causes for increased length of stay can save cost overall.

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