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

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...

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Autores principales: 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.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Spine Surgery 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7595819/
https://www.ncbi.nlm.nih.gov/pubmed/32810977
http://dx.doi.org/10.31616/asj.2020.0114
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author 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.
author_facet 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.
author_sort Reisener, Marie-Jacqueline
collection PubMed
description 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.
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spelling pubmed-75958192020-11-03 Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-Users 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. Asian Spine J Clinical Study 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. Korean Society of Spine Surgery 2020-10 2020-08-20 /pmc/articles/PMC7595819/ /pubmed/32810977 http://dx.doi.org/10.31616/asj.2020.0114 Text en Copyright © 2020 by Korean Society of Spine Surgery This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
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.
Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-Users
title Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-Users
title_full Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-Users
title_fullStr Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-Users
title_full_unstemmed Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-Users
title_short Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-Users
title_sort expectations of lumbar surgery outcomes among opioid users compared with non-users
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7595819/
https://www.ncbi.nlm.nih.gov/pubmed/32810977
http://dx.doi.org/10.31616/asj.2020.0114
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