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- Title
Opioid Use Disorder in Patients Undergoing Primary 1- to 2-Level Anterior Cervical Discectomy and Fusion Is Associated With Longer In-Hospital Lengths of Stay and Higher Rates of Readmissions, Complications, and Costs of Care.
- Authors
Kim, Nathan S.; Lam, Aaron W.; Golub, Ivan J.; Sheth, Bhavya K.; Vakharia, Rushabh M.; Saleh, Ahmed; Razi, Afshin E.
- Abstract
Study Design: Retrospective study. Objective: To determine whether opioid use disorder (OUD) patients undergoing 1- to 2-level anterior cervical discectomy and fusion (1-2ACDF) have higher rates of: 1) in-hospital lengths of stay (LOS); 2) readmissions; 3) complications; and 4) costs. Methods: OUD patients undergoing primary 1-2ACDF were identified within the Medicare database and matched to a control cohort in a 1:5 ratio by age, sex, and medical comorbidities. The query yielded 80,683 patients who underwent 1-2 ACDF with (n = 13,448) and without (n = 67,235) OUD. Outcomes analyzed included in-hospital LOS, 90-day readmission rates, 90-day medical complications, and costs. Multivariate logistic regression analyses were used to calculate odds-ratios (OR) for medical complications and readmissions. Welch's t -test was used to test for significance for LOS and cost between the cohorts. An alpha value less than 0.002 was considered statistically significant. Results: OUD patients were found to have significantly longer in-hospital LOS compared to their counterparts (3.41 vs. 2.23-days, P <.0001), in addition to higher frequency and odds of requiring readmissions (21.62 vs. 11.57%; OR: 1.38, P <.0001). Study group patients were found to have higher frequency and odds of developing medical complications (0.88 vs. 0.19%, OR: 2.80, P <.0001) and incurred higher episode of care costs ($20,399.62 vs. $16,812.14, P <.0001). Conclusion: The study can help to push orthopaedic surgeons in better managing OUD patients pre-operatively in terms of safe discontinuation and education of opioid drugs and their effects on complications, leading to more satisfactory outcomes.
- Subjects
OPIOID abuse; HOSPITALISTS; MEDICAL care costs; DISCECTOMY; PATIENT readmissions; LOGISTIC regression analysis; STATISTICAL hypothesis testing
- Publication
Global Spine Journal, 2023, Vol 13, Issue 6, p1467
- ISSN
2192-5682
- Publication type
Article
- DOI
10.1177/21925682211037265