Evidence map›Paper›PMID 33401866›Full record

ArticleNeurospine2020

Chronic Opioid Use Following Lumbar Discectomy: Prevalence, Risk Factors, and Current Trends in the United States.

Andrew B Harris, Bo Zhang, Majd Marrache, Varun Puvanesarajah, Micheal Raad, Hamid Hassanzadeh, Mark Bicket, Amit Jain

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurospine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
0.5field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 25 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Andrew B HarrisDepartment of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Bo ZhangDepartment of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Majd MarracheDepartment of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Varun PuvanesarajahDepartment of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Micheal RaadDepartment of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Hamid HassanzadehDepartment of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA.
Mark BicketDepartment of Anesthesiology, The Johns Hopkins University, Baltimore, MD, USA.
Amit JainDepartment of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Johns Hopkins University · USUniversity of Virginia · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveLumbar discectomy is commonly performed for symptomatic lumbar disc herniation. We aimed to examine prescribing patterns and risk factors for chronic opioid use following lumbar discectomy.

methodsUsing a private insurance claims database, patients were identified who underwent primary lumbar discectomy from 2010-2015 and had 1-year of continuous enrollment postoperatively. Patients were excluded with spinal fusion. The strength of opioid prescriptions was quantified using morphine milligram equivalents daily (MMED). Univariate and multivariate logistic regression models were built to examine risk factors associated with chronic postoperative opioid use.

resultsA total of 5,315 patients were included in the study (mean age, 59 years; 50% female). 1,198 of patients (23%) used chronic opioids postoperatively. Chronic opioid use declined significantly from 27% in 2010 to 17% in 2015, p < 0.001. In addition, there were significantly fewer patients receiving high and very high-dose opioid prescriptions from 2010-2015, p < 0.001. The median duration that patients used opioids postoperatively was 211 days in 2010 (interquartile range [IQR], 29-356 days), and decreased significantly to 44 days (IQR, 10-294 days) in 2015. The strongest factors associated with chronic opioid use were preoperative opioid use (odds ratio [OR], 4.0), drug abuse (OR, 2.6), depression (OR, 1.6), surgery in the west (OR, 1.6) or south (OR, 1.6), anxiety (OR, 1.5), or 30-day readmission (OR, 1.4).

conclusionChronic opioid use following primary lumbar discectomy has declined from 2010-2015. A variety of factors are associated with chronic opioid use. Preoperative recognition of some of these risk factors may aid in perioperative management and counseling.

Indexed as

DiskectomyLumbar vertebraeOpioid analgesicsPrevalenceRisk factor

Identifiers

PMID33401866
PMCPMC7788426
OpenAlexW3110978966

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.