| Popis: |
The purpose of this study is to determine if increased postoperative prescription opioid dosing is an isolated predictor of chronic opioid use after anterior cervical discectomy and fusion (ACDF).A retrospective cohort analysis of patients undergoing ACDF for degenerative diseases from 2016 - 2019 at a single institution was performed. Pre- and postoperative opioid and benzodiazepine prescriptions, including the morphine milligram equivalents (MME) and duration of use, were obtained from the Pennsylvania Prescription Drug Monitoring Program. Univariate analysis compared patient demographics and surgical factors across groups based on postoperative opioid dose (high: MME≥ 90, low: MME90) and chronicity of use (chronic: ≥ 120 days or10 prescriptions). Logistic regressions identified predictors of high opioid dose and chronic use.A total of 385 patients were included. Preoperative opioid tolerance and tobacco use were associated with high postoperative opioid dose and chronic usage. Younger age correlated with high dose prescriptions. Increased BMI and preoperative benzodiazepine use were associated with chronic opioid use. Chronic postoperative opioid use correlated with high dose prescriptions, change in opioid prescribed, private pay scripts, and greater than one prescriber and pharmacy. Logistic regression identified high postoperative opioid dose, opioid tolerance, increased BMI, and no prior cervical surgery as predictors of chronic opioid use. Regression analysis determined younger age, increased medical comorbidities, and opioid tolerance to be predictors for high MME prescriptions.High postoperative opioid dose independently predicted chronic opioid use after ACDF regardless of preoperative opioid tolerance. |
Full Text from ScienceDirect