PMID- 24296482
OWN - NLM
STAT- MEDLINE
DCOM- 20140815
LR  - 20151119
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 38
IP  - 25
DP  - 2013 Dec 1
TI  - Preoperative narcotic use and its relation to depression and anxiety in patients 
      undergoing spine surgery.
PG  - 2196-200
LID - 10.1097/BRS.0000000000000011 [doi]
AB  - STUDY DESIGN: Prospective review of registry data at a single institution from 
      October 2010 to June 2012. OBJECTIVE: To assess whether the amount of 
      preoperative narcotic use is associated with preoperative depression and anxiety 
      in patients undergoing spine surgery for a structural lesion. SUMMARY OF 
      BACKGROUND DATA: Previous work suggests that narcotic use and psychiatric 
      comorbidities are significantly related. Among other psychological 
      considerations, depression and anxiety may be associated with the amount of 
      preoperative narcotic use in patients undergoing spine surgery. METHODS: Five 
      hundred eighty-three patients undergoing lumbar (60%), thoracolumbar (11%), or 
      cervical spine (29%) were included. Self-reported preoperative narcotic 
      consumption was obtained at the initial preoperative visit and converted to daily 
      morphine equivalent amounts. Preoperative Zung Depression Scale (ZDS) and 
      Modified Somatic Perception Questionnaire (MSPQ) scores were also obtained at the 
      initial preoperative visit and recorded as measures of depression and anxiety, 
      respectively. Resistant and robust bootstrapped multivariable linear regression 
      analysis was performed to determine the association between ZDS and MSPQ scores 
      and preoperative narcotics, controlling for clinically important covariates. 
      Mann-Whitney U tests examined preoperative narcotic use in patients who were 
      categorized as depressed (ZDS >/= 33) or anxious (MSPQ >/= 12). RESULTS: 
      Multivariable analysis controlling for age, sex, smoking status, preoperative 
      employment status, and prior spinal surgery demonstrated that preoperative ZDS (P 
      = 0.006), prior spine surgery (P = 0.007), and preoperative pain (0.014) were 
      independent risk factors for preoperative narcotic use. Preoperative MSPQ (P = 
      0.083) was nearly a statistically significant risk factor. Patients who were 
      categorized as depressed or anxious on the basis of ZDS and MSPQ scores also 
      showed higher preoperative narcotic use than those who were not (P < 0.0001). 
      CONCLUSION: Depression and anxiety as assessed by ZDS and MSPQ scores were 
      significantly associated with increased preoperative narcotic use, underscoring 
      the importance of thorough psychological and substance use evaluation in patients 
      being evaluated for spine surgery.
FAU - Armaghani, Sheyan J
AU  - Armaghani SJ
AD  - *Department of Orthopaedics, Vanderbilt Orthopaedic Institute, Vanderbilt 
      University School of Medicine daggerDepartment of Neurological Surgery, Vanderbilt 
      University School of Medicine, Nashville, TN.
FAU - Lee, Dennis S
AU  - Lee DS
FAU - Bible, Jesse E
AU  - Bible JE
FAU - Archer, Kristin R
AU  - Archer KR
FAU - Shau, David N
AU  - Shau DN
FAU - Kay, Harrison
AU  - Kay H
FAU - Zhang, Chi
AU  - Zhang C
FAU - McGirt, Matthew J
AU  - McGirt MJ
FAU - Devin, Clinton J
AU  - Devin CJ
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
RN  - 0 (Narcotics)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Anxiety/chemically induced
MH  - Depression/*chemically induced
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Narcotics/*adverse effects/pharmacology
MH  - Pain Measurement
MH  - Postoperative Complications/*etiology
MH  - Prospective Studies
MH  - Psychiatric Status Rating Scales
MH  - Spine/*surgery
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2013/12/04 06:00
MHDA- 2014/08/16 06:00
CRDT- 2013/12/04 06:00
PHST- 2013/12/04 06:00 [entrez]
PHST- 2013/12/04 06:00 [pubmed]
PHST- 2014/08/16 06:00 [medline]
AID - 00007632-201312010-00012 [pii]
AID - 10.1097/BRS.0000000000000011 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2013 Dec 1;38(25):2196-200. doi: 
      10.1097/BRS.0000000000000011.