잠시만 기다려 주세요. 로딩중입니다.

Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-Users

Asian Spine Journal 2020년 14권 5호 p.663 ~ 672
Reisener Marie-Jacqueline, Hughes Alexander P., Schadler Paul, Forman Alexa, Sax Oliver C., Shue Jennifer, Cammisa Frank P., Sama Andrew A., Girardi Federico P., Mancuso Carol A.,
소속 상세정보
 ( Reisener Marie-Jacqueline ) - Hospital for Special Surgery Department of Orthopedic Surgery
 ( Hughes Alexander P. ) - Hospital for Special Surgery Department of Orthopedic Surgery
 ( Schadler Paul ) - Hospital for Special Surgery Department of Orthopedic Surgery
 ( Forman Alexa ) - Hospital for Special Surgery Department of Orthopedic Surgery
 ( Sax Oliver C. ) - Hospital for Special Surgery Department of Orthopedic Surgery
 ( Shue Jennifer ) - Hospital for Special Surgery Department of Orthopedic Surgery
 ( Cammisa Frank P. ) - Hospital for Special Surgery Department of Orthopedic Surgery
 ( Sama Andrew A. ) - Hospital for Special Surgery Department of Orthopedic Surgery
 ( Girardi Federico P. ) - Hospital for Special Surgery Department of Orthopedic Surgery
 ( Mancuso Carol A. ) - Hospital for Special Surgery Department of Medicine

Abstract


Study Design: Matched cohort study.

Purpose: To compare and describe the effect of opioid usage on the expectations of lumbar surgery outcomes among patients taking opioids and patients not taking opioids.

Overview of Literature: Chronic opioid use is common among lumbar-spine surgery patients. The decision to undergo elective lumbar surgery is influenced by the expected surgery outcomes. However, the effects of opioids on patients’ expectations of lumbar surgery outcomes remain to be rigorously assessed.

Methods: A total of 77 opioid users grouped according to dose and duration (54 “higher users,” 30 “lower users”) were matched 2:1 to 154 non-opioid users based on age, sex, marital status, chiropractic care, disability, and diagnosis. All patients completed a validated 20-item Expectations Survey measuring expected improvement with regard to symptoms, function, psychological well-being, and anticipated future spine condition. “Greater expectations” was defined as a higher survey score (possible range, 0?100) based on the number of items expected and degree of improvement expected.

Results: The mean Expectations Survey scores for all opioid users and all non-users were similar (73 vs. 70, p=0.18). Scores were different, however, for lower users (79) compared with matched non-users (69, p=0.01) and compared with higher users (70, p=0.01). In multivariable analysis, “greater expectations” was independently associated with having had chiropractic care (p=0.03), being more disabled (p=0.002), and being a lower-dose opioid user (p=0.03). Compared with higher users, lower users were also more likely to expect not to need pain medications 2 years after surgery (47% vs. 83%, p=0.003).

Conclusions: Patient expectations of lumbar surgery are associated with diverse demographic and clinical variables. A lower dose and shorter duration of opioid use were associated with expecting more items and expecting more complete improvement compared with non-users. In addition, lower opioid users had greater overall expectations compared with higher users.

키워드

Expectations; Lumbar surgery; Opioids; Lower-back pain

원문 및 링크아웃 정보

 

등재저널 정보