Evidence map›Paper›PMID 38925858›Full record

ArticleCanadian journal of surgery. Journal canadien de chirurgie

Postdischarge opioid use after lumbar spine surgery among older adults in Ontario: a population-based cohort study.

Ana Johnson, Francis Nguyen, Melissa Richardson, Sarah Rabi, Steve Mann, Ian Gilron, Jeff Yach, Brian Milne, Gerald Evans, Joel Parlow

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Canadian journal of surgery. Journal canadien de chirurgie. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
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

10 authors.

Ana JohnsonFrom the Department of Public Health Sciences, Queen's University, Kingston, Ont. (Johnson); ICES Queen's (Johnson), Queen's University, Kingston, Ont.; ICES McMaster, McMaster University, Hamilton, Ont. (Nguyen); the School of Rehabilitation Therapy, Queen's University, Kingston, Ont. (Richardson); the Department of Community Health Sciences, University of Calgary, Calgary, Alta. (Rabi); the Department of Surgery, Queen's University, Kingston, Ont. (Mann, Yach); the Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ont. (Gilron, Milne, Parlow); the Department of Medicine, Queen's University, Kingston, Ont. (Evans).
Francis NguyenFrom the Department of Public Health Sciences, Queen's University, Kingston, Ont. (Johnson); ICES Queen's (Johnson), Queen's University, Kingston, Ont.; ICES McMaster, McMaster University, Hamilton, Ont. (Nguyen); the School of Rehabilitation Therapy, Queen's University, Kingston, Ont. (Richardson); the Department of Community Health Sciences, University of Calgary, Calgary, Alta. (Rabi); the Department of Surgery, Queen's University, Kingston, Ont. (Mann, Yach); the Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ont. (Gilron, Milne, Parlow); the Department of Medicine, Queen's University, Kingston, Ont. (Evans).
Melissa RichardsonFrom the Department of Public Health Sciences, Queen's University, Kingston, Ont. (Johnson); ICES Queen's (Johnson), Queen's University, Kingston, Ont.; ICES McMaster, McMaster University, Hamilton, Ont. (Nguyen); the School of Rehabilitation Therapy, Queen's University, Kingston, Ont. (Richardson); the Department of Community Health Sciences, University of Calgary, Calgary, Alta. (Rabi); the Department of Surgery, Queen's University, Kingston, Ont. (Mann, Yach); the Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ont. (Gilron, Milne, Parlow); the Department of Medicine, Queen's University, Kingston, Ont. (Evans).
Sarah RabiFrom the Department of Public Health Sciences, Queen's University, Kingston, Ont. (Johnson); ICES Queen's (Johnson), Queen's University, Kingston, Ont.; ICES McMaster, McMaster University, Hamilton, Ont. (Nguyen); the School of Rehabilitation Therapy, Queen's University, Kingston, Ont. (Richardson); the Department of Community Health Sciences, University of Calgary, Calgary, Alta. (Rabi); the Department of Surgery, Queen's University, Kingston, Ont. (Mann, Yach); the Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ont. (Gilron, Milne, Parlow); the Department of Medicine, Queen's University, Kingston, Ont. (Evans).
Steve MannFrom the Department of Public Health Sciences, Queen's University, Kingston, Ont. (Johnson); ICES Queen's (Johnson), Queen's University, Kingston, Ont.; ICES McMaster, McMaster University, Hamilton, Ont. (Nguyen); the School of Rehabilitation Therapy, Queen's University, Kingston, Ont. (Richardson); the Department of Community Health Sciences, University of Calgary, Calgary, Alta. (Rabi); the Department of Surgery, Queen's University, Kingston, Ont. (Mann, Yach); the Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ont. (Gilron, Milne, Parlow); the Department of Medicine, Queen's University, Kingston, Ont. (Evans).
Ian GilronFrom the Department of Public Health Sciences, Queen's University, Kingston, Ont. (Johnson); ICES Queen's (Johnson), Queen's University, Kingston, Ont.; ICES McMaster, McMaster University, Hamilton, Ont. (Nguyen); the School of Rehabilitation Therapy, Queen's University, Kingston, Ont. (Richardson); the Department of Community Health Sciences, University of Calgary, Calgary, Alta. (Rabi); the Department of Surgery, Queen's University, Kingston, Ont. (Mann, Yach); the Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ont. (Gilron, Milne, Parlow); the Department of Medicine, Queen's University, Kingston, Ont. (Evans).
Jeff YachFrom the Department of Public Health Sciences, Queen's University, Kingston, Ont. (Johnson); ICES Queen's (Johnson), Queen's University, Kingston, Ont.; ICES McMaster, McMaster University, Hamilton, Ont. (Nguyen); the School of Rehabilitation Therapy, Queen's University, Kingston, Ont. (Richardson); the Department of Community Health Sciences, University of Calgary, Calgary, Alta. (Rabi); the Department of Surgery, Queen's University, Kingston, Ont. (Mann, Yach); the Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ont. (Gilron, Milne, Parlow); the Department of Medicine, Queen's University, Kingston, Ont. (Evans).
Brian MilneFrom the Department of Public Health Sciences, Queen's University, Kingston, Ont. (Johnson); ICES Queen's (Johnson), Queen's University, Kingston, Ont.; ICES McMaster, McMaster University, Hamilton, Ont. (Nguyen); the School of Rehabilitation Therapy, Queen's University, Kingston, Ont. (Richardson); the Department of Community Health Sciences, University of Calgary, Calgary, Alta. (Rabi); the Department of Surgery, Queen's University, Kingston, Ont. (Mann, Yach); the Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ont. (Gilron, Milne, Parlow); the Department of Medicine, Queen's University, Kingston, Ont. (Evans).
Gerald EvansFrom the Department of Public Health Sciences, Queen's University, Kingston, Ont. (Johnson); ICES Queen's (Johnson), Queen's University, Kingston, Ont.; ICES McMaster, McMaster University, Hamilton, Ont. (Nguyen); the School of Rehabilitation Therapy, Queen's University, Kingston, Ont. (Richardson); the Department of Community Health Sciences, University of Calgary, Calgary, Alta. (Rabi); the Department of Surgery, Queen's University, Kingston, Ont. (Mann, Yach); the Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ont. (Gilron, Milne, Parlow); the Department of Medicine, Queen's University, Kingston, Ont. (Evans).
Joel ParlowFrom the Department of Public Health Sciences, Queen's University, Kingston, Ont. (Johnson); ICES Queen's (Johnson), Queen's University, Kingston, Ont.; ICES McMaster, McMaster University, Hamilton, Ont. (Nguyen); the School of Rehabilitation Therapy, Queen's University, Kingston, Ont. (Richardson); the Department of Community Health Sciences, University of Calgary, Calgary, Alta. (Rabi); the Department of Surgery, Queen's University, Kingston, Ont. (Mann, Yach); the Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ont. (Gilron, Milne, Parlow); the Department of Medicine, Queen's University, Kingston, Ont. (Evans).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrescription opioid use places a considerable economic burden on health care systems. Older patients undergoing surgical procedures for painful conditions commonly receive opioids pre- and postoperatively, and are susceptible to adverse reactions. This study explores predictors of prolonged postoperative opioid use among older patients after lumbar spine surgery and the consequences in terms of health care utilization and costs.

methodsWe conducted a retrospective population-based cohort study using Ontario administrative data from older adults undergoing spine surgery between 2006 and 2017. Data were analyzed from 90 days preoperatively to 1 year after hospital discharge, with last postoperative opioid prescriptions stratified into 90-day increments. We used multivariable ordinal logistic regression to identify predictors of long-term opioid use and generalized linear modelling to examine resource utilization and health care costs (2021 Canadian dollars).

resultsOf 15 109 patients included, 40.8% received preoperative opioid prescriptions. Preoperative opioid use strongly predicted prolonged postoperative use (odds ratio [OR] 4.47, 95% confidence interval [CI] 4.16-4.79), with 48.3% of patients who received preoperative opioids continuing to use opioids for longer than 9 months, relative to 12.7% of those without preoperative use. Several other risk factors for prolonged use were identified. Patients receiving long-term postoperative opioids incurred greater health care costs relative to those with opioids prescribed for fewer than 90 days (OR 1.49, 95% CI 1.44-1.54).

conclusionAmong older adults undergoing spine surgery, preoperative opioid use was a strong predictor of prolonged postoperative use, which was associated with increased health care costs. These results form an important baseline for future studies evaluating strategies to reduce opioid use targeting older surgical populations.

Indexed as

Analgesics, OpioidLumbar VertebraePostoperative PainAgedAged, 80 and overCohort StudiesFemaleHumansMaleOntarioPatient DischargeRetrospective StudiesAnalgesics, Opioid

Identifiers

PMID38925858
PMCPMC11230664

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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.