Journal article
Does Preoperative Opiate Choice Increase Risk of Postoperative Infection and Subsequent Surgery?
World neurosurgery, v 170, pp E467-E490
01 Feb 2023
PMID: 36396056
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND: Opioids are commonly prescribed for chronic pain before spinal surgery and research has shown an increased rate of postoperative adverse events in these patients. OBJECTIVE: This study compared the incidence of 2-year subsequent surgical procedures and postoperative adverse events in patients undergoing lumbar fusion with or without 90-day preoperative opioid use. We hypothesized that patients using preoperative opioids would have a higher incidence of subsequent surgery and adverse outcomes. METHODS: A retrospective cohort study was performed using the Optum Pan-Therapeutic Electronic Health Re- cords database including adult patients who had their first lumbar fusion between 2015 and 2018. The daily average preoperative opioid dosage 90 days before fusion was determined as morphine equivalent dose and further categorized into high dose (morphine equivalent dose >100 mg/day) and low dose (1-100 mg/day). Clinical outcomes were compared after adjusting for confounders. RESULTS: A total of 23,275 patients were included, with 2112 patients (10%) using opioids preoperatively. There was a significantly higher incidence of infection compared with nonusers (12.3% vs. 10.1%; P = 0.01). There was no association between subsequent fusion surgery (7.9% vs. 75%; P = 0.52) and subsequent decompression surgery (4.1% vs. 3.6%; P = 0.3) between opioid users and non- users. Regarding postoperative infection risk, low-dose users showed significantly higher incidence (12.7% vs. 10.1% <0.01), but high-dose users did not show higher incidence than nonusers (7.5% vs. 10.1%; P = 0.23). CONCLUSIONS: Consistent with previous studies, opioid use was significantly associated with a higher incidence of 2-year postoperative infection compared with nonuse. Low-dose opioid users had higher postoperative infection rates than did nonusers.
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Details
- Title
- Does Preoperative Opiate Choice Increase Risk of Postoperative Infection and Subsequent Surgery?
- Creators
- Glenn A. Gonzalez - Jefferson Hospital for NeuroscienceKatherine Corso - Johnson & JohnsonJingya Miao - Drexel UniversitySidharth K. Rajappan - Mu Sigma, Bengaluru, Karnataka, IndiaGuilherme Porto - Jefferson Hospital for NeuroscienceManoranjith Anandan - Mu Sigma, Bengaluru, Karnataka, IndiaMatthew O'Leary - Drexel Univ Coll Med, Dept Med, Philadelphia, PA USAJohn Wainwright - Thomas Jefferson UniversityRupert Smit - Jefferson Hospital for NeuroscienceKevin Hines - Jefferson Hospital for NeuroscienceDaniel Franco - Jefferson Hospital for NeuroscienceAria Mahtabfar - Jefferson Hospital for NeuroscienceCristian DeSimone - Jefferson Hospital for NeuroscienceDiego Polanco - Jefferson Hospital for NeuroscienceReyan Qasba - Jefferson Hospital for NeuroscienceSara Thalheimer - Thomas Jefferson Univ, Jefferson Hosp Neurosci, Dept Neurosurg, Philadelphia, PA 19144 USAJoshua E. Heller - Thomas Jefferson UniversityAshwini Sharan - Thomas Jefferson UniversityJack Jallo - Thomas Jefferson University HospitalJames Harrop - Thomas Jefferson University
- Publication Details
- World neurosurgery, v 170, pp E467-E490
- Publisher
- Elsevier
- Number of pages
- 24
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000947157400001
- Scopus ID
- 2-s2.0-85145212847
- Other Identifier
- 991021861197804721
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- Collaboration types
- Industry collaboration
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery