Smoking status, BMI predict prolonged opioid use after lumbar fusion
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According to published results, current smoking status and a BMI greater than 35 kg/m2 “significantly predicted” prolonged opioid usage after lumbar decompression and fusion surgery.
Jose A. Canseco, MD, PhD, and colleagues from Rothman Orthopaedic Institute retrospectively analyzed data on 260 patients who underwent 1 to 3 level lumbar decompression and fusion with a minimum 1-year follow-up between 2013 and 2017. The researchers made note of patients who were deemed preoperative chronic opioid users — defined as consumption of opioids for more than 90 days in the year before surgery. They also defined postoperative prolonged opioid use as a filled prescription 90 days after surgery.
According to the study, patient-reported outcome measures (PROMs) included the short form-12 survey physical component score and mental component score (MCS-12), Oswestry Disability Index and VAS pain scores.
After logistic regression analysis, Canseco and colleagues determined that a BMI of greater than 35 kg/m2 (OR = .44; 95% CI, 0.2-0.9) and current smoking status (OR = 2.73; 95% CI, 1.14-6.96) significantly predicted postoperative opioid usage and excessive opioid use before and after surgery significantly affected PROMs.
Patients who were deemed chronic preoperative opioid users saw the greatest improvements in MCS-12 (P = .02), the researchers noted. Additionally, patients who were deemed prolonged postoperative opioid users self-reported worse postoperative VAS pain scores for the back (P = .003) and leg (P = .03) after surgery.
“This study set out to ascertain risk factors associated with prolonged opioid use after lumbar surgery and elucidate the relationship between chronic preoperative opioid use, prolonged postoperative opioid use and PROMs,” the researchers wrote in the study. “Current smoking status and lower BMI were significantly predictive of prolonged opioid use. Excess opioid use before and after surgery significantly affected PROMs,” they concluded.
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