PMID- 34130382
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220514
IS  - 1976-1902 (Print)
IS  - 1976-7846 (Electronic)
IS  - 1976-1902 (Linking)
VI  - 16
IP  - 2
DP  - 2022 Apr
TI  - The Influence of Preoperative Narcotic Consumption on Patient-Reported Outcomes 
      of Lumbar Decompression.
PG  - 195-203
LID - 10.31616/asj.2020.0582 [doi]
AB  - STUDY DESIGN: Retrospective cohort. PURPOSE: This study aimed to assess the 
      relationship between preoperative narcotic consumption and patient-reported 
      outcomes (PRO) in patients undergoing minimally invasive (MIS) lumbar 
      decompression (LD). OVERVIEW OF LITERATURE: Previous studies report negative 
      effects of narcotic consumption on perioperative outcomes and recovery; however, 
      its impact on quality of life and surgical outcomes is not fully understood. 
      METHODS: A surgical database was retrospectively reviewed for patients undergoing 
      primary, single-level MIS LD from 2013 to 2020. Patients lacking preoperative 
      narcotic consumption data were excluded. Demographics, spinal pathologies, and 
      operative characteristics were collected. Patients were grouped based on 
      preoperative narcotic consumption. Patient Health Questionnaire-9 (PHQ-9), Visual 
      Analog Scale (VAS) for back and leg, Oswestry Disability Index (ODI), 12-item 
      Short Form Physical Component Summary, and Patient-Reported Outcomes Measurement 
      Information System physical function (PROMIS-PF) were collected preoperatively 
      and postoperatively. Preestablished values were used to calculate achievement of 
      minimum clinically important difference (MCID). Differences in mean PROs and MCID 
      achievement between groups were evaluated. RESULTS: The cohort was 453 patients; 
      184 used preoperative narcotics and 269 did not. Significant differences were 
      found in American Society of Anesthesiologists classification, ethnicity, 
      insurance type, and estimated blood loss between groups. Significant differences 
      were also found in preoperative PHQ-9, VAS leg, ODI, and PROMIS-PF between groups 
      (all p<0.05). Mean postoperative PROs did not differ by group (p>0.05). A higher 
      rate of MCID achievement was associated with the narcotic group for PHQ-9 and 
      PROMIS-PF at 6 weeks (both p</=0.050), VAS leg at 1 year (p=0.009), and overall for 
      ODI and PHQ-9 (both p</=0.050). CONCLUSIONS: Preoperative narcotic consumption was 
      associated with worse preoperative depression, leg pain, disability, and physical 
      function. In patients consuming preoperative narcotics, a higher proportion 
      achieved an overall MCID for disability and depressive symptoms. Patients taking 
      preoperative narcotic medications may report significantly worse preoperative 
      PROs but demonstrate greater improvements in postoperative disability and mental 
      health.
FAU - Lynch, Conor P
AU  - Lynch CP
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Cha, Elliot D K
AU  - Cha EDK
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Mohan, Shruthi
AU  - Mohan S
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Geoghegan, Cara E
AU  - Geoghegan CE
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Jadczak, Caroline N
AU  - Jadczak CN
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Singh, Kern
AU  - Singh K
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
LA  - eng
PT  - Journal Article
DEP - 20210617
PL  - Korea (South)
TA  - Asian Spine J
JT  - Asian spine journal
JID - 101314177
PMC - PMC9066254
OTO - NOTNLM
OT  - Minimal clinically important difference
OT  - Narcotics
OT  - Patient health questionnaire
OT  - Patient reported outcome measures
COIS- No potential conflict of interest relevant to this article was reported.
EDAT- 2021/06/17 06:00
MHDA- 2021/06/17 06:01
PMCR- 2022/04/01
CRDT- 2021/06/16 01:29
PHST- 2021/02/17 00:00 [received]
PHST- 2021/03/17 00:00 [accepted]
PHST- 2021/06/17 06:00 [pubmed]
PHST- 2021/06/17 06:01 [medline]
PHST- 2021/06/16 01:29 [entrez]
PHST- 2022/04/01 00:00 [pmc-release]
AID - asj.2020.0582 [pii]
AID - asj-2020-0582 [pii]
AID - 10.31616/asj.2020.0582 [doi]
PST - ppublish
SO  - Asian Spine J. 2022 Apr;16(2):195-203. doi: 10.31616/asj.2020.0582. Epub 2021 Jun 
      17.