Development and Internal Validation of the Postoperative Analgesic Intake Needs Score: A Predictive Model for Post-Operative Narcotic Requirement after Spine Surgery.

Autor:	Johnson ZD; Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA., Connors SW; Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA., Christian Z; Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA., Badejo O; Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA., Adeyemo E; Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA., Pernik MN; Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA., Barrie U; Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA., Caruso JP; Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA., Kafka B; Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA., Neeley OJ; Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA., Hall K; Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA., El Ahmadieh TY; Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA., Dahdaleh NS; Department of Neurological Surgery, Northwestern University Medical Center, Dallas, TX, USA., Reisch JS; Department of Population and Data Sciences, Division of Biostatistics, The University of Texas Southwestern Medical Center, Dallas, TX, USA., Aoun SG; Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA., Bagley CA; Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA.; Department of Orthopedic Surgery, The University Texas Southwestern Medical Center, Dallas, TX, USA.
Jazyk:	angličtina
Zdroj:	Global spine journal [Global Spine J] 2023 Oct; Vol. 13 (8), pp. 2135-2143. Date of Electronic Publication: 2022 Jan 20.
DOI:	10.1177/21925682211072490
Abstrakt:	Study Design: Retrospective Cohort. Objective: The aim of this study was to develop a clinical tool to pre-operatively risk-stratify patients undergoing spine surgery based on their likelihood to have high postoperative analgesic requirements. Methods: A total of 1199 consecutive patients undergoing elective spine surgery over a 2-year period at a single center were included. Patients not requiring inpatient admission, those who received epidural analgesia, those who had two surgeries at separate sites under one anesthesia event, and those with a length of stay greater than 10 days were excluded. The remaining 860 patients were divided into a derivation and validation cohort. Pre-operative factors were collected by review of the electronic medical record. Total postoperative inpatient opioid intake requirements were converted into morphine milligram equivalents to standardize postoperative analgesic requirements. Results: The postoperative analgesic intake needs (PAIN) score was developed after the following predictor variables were identified: age, race, history of depression/anxiety, smoking status, active pre-operative benzodiazepine use and pre-operative opioid use, and surgical type. Patients were risk-stratified based on their score with the high-risk group being more likely to have high opioid consumption postoperatively compared to the moderate and low-risk groups in both the derivation and validation cohorts. Conclusion: The PAIN Score is a pre-operative clinical tool for patients undergoing spine surgery to risk stratify them based on their likelihood for high analgesic requirements. The information can be used to individualize a multi-modal analgesic regimen rather than utilizing a "one-size fits all" approach.
Databáze:	MEDLINE
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