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No correlation seen between preoperative narcotic use, patient satisfaction after spine surgery
In patients who underwent elective spine surgery, no significant correlation was seen between preoperative narcotic use and perioperative adverse outcomes or hospitalization satisfaction scores, according to recently published results.
In a retrospective cohort study, researchers identified 346 patients who underwent elective spine surgery. Investigators assessed the NarxCare narcotics use score at the time of admission. Medical records were used to obtain patient characteristics, 30-day adverse events, readmissions, reoperations and morality. When available, the Hospital Consumer Assessment of Heath Care Providers and Systems survey data was obtained.
Patients were grouped based on ranges of admission NarxCare scores: 74 patients had a score of 0; 58 patients had a score of 1 to 99; 117 patients had a score of 300 to 499; and 21 patients had a score of 500 or more. The odds of adverse events, readmission, reoperation and mortality were compared between the narcotics groups with multivariate logistic regression. Survey response rates and results were compared between the different narcotics score groups with one-way ANOVA analysis.
Results from the multivariate logistic regressions did not detect statistically significant differences in the odds of adverse events, readmission, reoperation or mortality among the different groups of admissions narcotics scores. No statistically significant differences were seen between the survey response rates, total survey score or sub-group scores between the different narcotic score groups, according to analyses of variance results. – by Monica Jaramillo
Disclosures: The authors report no relevant financial disclosures.
Perspective
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Prevalence of preoperative use of opioids is high in patients undergoing spine surgery. Given that preoperative narcotics use may be a modifiable risk factor in patients undergoing spine surgery, understanding the impact on surgical outcomes and patient satisfaction can guide future preoperative optimization and perioperative opioid-weaning protocols.
Galivanche and colleagues performed a retrospective analysis of 346 patients undergoing elective spine surgery to evaluate the relationship of preoperative opioid use on perioperative patient outcomes and satisfaction. Patients were grouped by their preoperative narcotics use scores (NarxCare), and satisfaction scores were obtained by the Hospital Consumer Assessment of Healthcare Providers and Systems data. The authors did not detect a relationship between preoperative patient narcotic utilization with perioperative adverse events, 30-day readmission, reoperation or mortality rates or patient satisfaction scores.
The study could be strengthened with additional analyses on preoperative and postoperative health-related quality of life scores and postoperative narcotic usage. As spine surgeons, the goal is to identify which patients would most benefit from surgical management and how to optimize patients preoperatively for the best outcomes. This study provides level 3 data that the preoperative evaluation of narcotic usage may not have a significant impact on patient outcome or satisfaction scores.
Neurological surgery
University of Southern California Spine Center
Los Angeles
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