PMID- 36208431
OWN - NLM
STAT- MEDLINE
DCOM- 20230203
LR  - 20230322
IS  - 1547-5646 (Electronic)
IS  - 1547-5646 (Linking)
VI  - 38
IP  - 2
DP  - 2023 Feb 1
TI  - Postoperative opioid prescription and patient-reported outcomes after elective 
      spine surgery: a Michigan Spine Surgery Improvement Collaborative study.
PG  - 242-248
LID - 10.3171/2022.8.SPINE22571 [doi]
AB  - OBJECTIVE: This study was designed to assess how postoperative opioid 
      prescription dosage could affect patient-reported outcomes after elective spine 
      surgery. METHODS: Patients enrolled in the Michigan Spine Surgery Improvement 
      Collaborative (MSSIC) from January 2020 to September 2021 were included in this 
      study. Opioid prescriptions at discharge were converted to total morphine 
      milligram equivalents (MME). A reference value of 225 MME per week was used as a 
      cutoff. Patients were divided into two cohorts based on prescribed total MME: </= 
      225 MME and > 225 MME. Primary outcomes included patient satisfaction, return to 
      work status after surgery, and whether improvement of the minimal clinically 
      important difference (MCID) of the Patient-Reported Outcomes Measurement 
      Information System 4-question short form for physical function (PROMIS PF) and 
      EQ-5D was met. Generalized estimated equations were used for multivariate 
      analysis. RESULTS: Regression analysis revealed that patients who had 
      postoperative opioids prescribed with > 225 MME were less likely to be satisfied 
      with surgery (adjusted OR [aOR] 0.81) and achieve PROMIS PF MCID (aOR 0.88). They 
      were also more likely to be opioid dependent at 90 days after elective spine 
      surgery (aOR 1.56). CONCLUSIONS: The opioid epidemic is a serious threat to 
      national public health, and spine surgeons must practice conscientious 
      postoperative opioid prescribing to achieve adequate pain control. The authors' 
      analysis illustrates that a postoperative opioid prescription of 225 MME or less 
      is associated with improved patient satisfaction, greater improvement in physical 
      function, and decreased opioid dependence compared with those who had > 225 MME 
      prescribed.
FAU - Lim, Seokchun
AU  - Lim S
AD  - Departments of1Neurological Surgery.
FAU - Yeh, Hsueh-Han
AU  - Yeh HH
AD  - 2Public Health Services, and.
FAU - Macki, Mohamed
AU  - Macki M
AD  - Departments of1Neurological Surgery.
FAU - Haider, Sameah
AU  - Haider S
AD  - Departments of1Neurological Surgery.
FAU - Hamilton, Travis
AU  - Hamilton T
AD  - Departments of1Neurological Surgery.
FAU - Mansour, Tarek R
AU  - Mansour TR
AD  - Departments of1Neurological Surgery.
FAU - Telemi, Edvin
AU  - Telemi E
AD  - Departments of1Neurological Surgery.
FAU - Schultz, Lonni
AU  - Schultz L
AD  - Departments of1Neurological Surgery.
AD  - 2Public Health Services, and.
FAU - Nerenz, David R
AU  - Nerenz DR
AD  - Departments of1Neurological Surgery.
AD  - 3Center for Health Policy and Health Services Research, Henry Ford Health, 
      Detroit, Michigan.
FAU - Schwalb, Jason M
AU  - Schwalb JM
AD  - Departments of1Neurological Surgery.
FAU - Abdulhak, Muwaffak
AU  - Abdulhak M
AD  - Departments of1Neurological Surgery.
FAU - Park, Paul
AU  - Park P
AD  - Departments of4Neurosurgery and.
FAU - Aleem, Ilyas
AU  - Aleem I
AD  - 5Orthopedics, University of Michigan, Ann Arbor, Michigan.
FAU - Easton, Richard
AU  - Easton R
AD  - 6Department of Orthopedics, William Beaumont Hospital, Troy, Michigan; and.
FAU - Khalil, Jad G
AU  - Khalil JG
AD  - Departments of7Orthopedics and.
FAU - Perez-Cruet, Miguelangelo
AU  - Perez-Cruet M
AD  - 8Neurosurgery, William Beaumont Hospital, Royal Oak, Michigan.
FAU - Chang, Victor
AU  - Chang V
AD  - Departments of1Neurological Surgery.
LA  - eng
PT  - Journal Article
DEP - 20221007
PL  - United States
TA  - J Neurosurg Spine
JT  - Journal of neurosurgery. Spine
JID - 101223545
RN  - 0 (Analgesics, Opioid)
RN  - 78185-58-7 (MME)
SB  - IM
MH  - Humans
MH  - *Analgesics, Opioid/therapeutic use
MH  - Michigan/epidemiology
MH  - *Practice Patterns, Physicians'
MH  - Prescriptions
MH  - Patient Reported Outcome Measures
MH  - Pain, Postoperative/drug therapy
MH  - Retrospective Studies
OTO - NOTNLM
OT  - MSSIC
OT  - Michigan Spine Surgery Improvement Collaborative
OT  - opioid
OT  - pain
OT  - patient-reported outcome
OT  - satisfaction
OT  - spine surgery
EDAT- 2022/10/09 06:00
MHDA- 2023/02/04 06:00
CRDT- 2022/10/08 12:02
PHST- 2022/05/26 00:00 [received]
PHST- 2022/08/25 00:00 [accepted]
PHST- 2022/10/09 06:00 [pubmed]
PHST- 2023/02/04 06:00 [medline]
PHST- 2022/10/08 12:02 [entrez]
AID - 10.3171/2022.8.SPINE22571 [doi]
PST - epublish
SO  - J Neurosurg Spine. 2022 Oct 7;38(2):242-248. doi: 10.3171/2022.8.SPINE22571. 
      Print 2023 Feb 1.