P42. Can 6- and 12-month opioid usage predict long-term opioid use in ASD patients?

• Published in: The spine journal 2019-09, Vol.19 (9), p.S178-S178
• Main Authors: Ren, Mark, Bryant, Barry R., Harris, Andrew B., Skolasky, Richard L., Kebaish, Khaled M., Riley, Lee H., Cohen, David B., Neuman, Brian J.
• Format: Article
• Language: English
• ISSN: 1529-9430; 1878-1632
• DOI: 10.1016/j.spinee.2019.05.466

Long-term opioid use is common among ASD patients, and it is a cause of significant morbidity. This study aims to evaluate whether opioid use at 6 and 12 months post-surgery are predictive of long-term use at 2 years following surgery. Retrospective cohort study. Retrospective review of all ASD surgical patients treated at a single center between January 1, 2013 and December 31, 2016 with 2-year follow-up. Self-reported opioid use at 2-year follow-up. Retrospective review of all ASD surgical patients treated at a single center with 2-year follow-up. Patient demographics, surgical details and self-reported daily opioid use at each visit were collected. Clinical records were reviewed for the preoperative evaluation and each postoperative visit (1.5, 3, 6, 12 and 24 months). Patients who restarted opioid use in the follow-up period due to a revision or other surgery were excluded. Patients were classified as opioid-users if they reported taking opioid medications during their preoperative evaluation and as opioid-naïve if they did not. Logistic regression including age, sex, preoperative opioid use, ASA score, and number of vertebral levels fused was used to evaluate 6- and 12-month postoperative opioid use as risk factors for 2-year opioid use. A total of 60 patients met the inclusion criteria and had 2-year follow-up including self-reported opioid intake. Seventy-seven percent (46) of patients were classified as opioid-users and 23% (14) were classified as opioid-naïve. Forty-nine percent (20/41) of patients reporting opioid use at 6 months post-surgery and 29% (9/31) of patients reporting use at 12 months ceased opioid use by 2-year follow-up. Opioid usage at 12-month follow-up independently predicts opioid use at 2-year follow-up (adjusted OR = 16.3, 95% CI: [4.0, 113.4], p < 0.001), while usage at 6-month follow-up does not (p = 0.10).When comparing preoperative opioid users to opioid-naïve patients, the opioid-user group had a significantly greater rate of reported postoperative opioid use at each time point post-surgery (p < 0.01). For example, 85%, 64%, and 54% of patients in the opioid-user group reported continuing opioid use at 6-month, 12-month, and 2-year follow-up, compared with 43%, 17%, and 7% of opioid-naïve patients, respectively. Opioid use at 12 months is a strong independent predictor of opioid use at 2-year follow-up, while nearly half of patients using opioids 6 months post-surgery successfully cease opioids within 2 years. ASD patients