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Opioid Use Disorder Among Cervical Fusion Inpatients: Trends, Complications, and Resource Use in a Retrospective
Mitchell K Ng1, Leonidas E Mastrokostas2,3, Paul G Mastrokostas2,3
1Thomas Jefferson University Hospital, Rothman Orthopaedic Institute, Philadelphia, PA, USA.
Adults with opioid use disorder (OUD) undergoing cervical fusion face increased complications and resource use. Tailored perioperative care is crucial for this complex patient group to improve outcomes.
Area of Science:
- Neurosurgery
- Addiction Medicine
- Health Services Research
Background:
- Opioid use disorder (OUD) presents unique challenges in surgical populations.
- Cervical fusion surgery involves significant perioperative considerations.
Purpose of the Study:
- To analyze temporal trends of OUD in adults undergoing inpatient cervical fusion.
- To identify factors associated with OUD in this cohort.
- To compare resource utilization and complication rates between patients with and without OUD.
Main Methods:
- Retrospective cohort study utilizing the National Inpatient Sample (NIS) from 2016-2022.
- OUD identification via ICD-10-CM codes.
- Multivariable logistic regression to assess risk factors, complications, and discharge outcomes.
Main Results:
- OUD prevalence increased with age and clinical severity.
- OUD patients had higher rates of multilevel fusion, mental illness, and substance abuse.
- OUD was linked to increased cardiovascular and mechanical complications, longer stays, and higher costs.
Conclusions:
- Patients with OUD undergoing cervical fusion represent a complex, high-resource subgroup.
- This population experiences elevated risks for adverse events and non-routine discharges.
- Developing targeted risk stratification and OUD-specific perioperative pathways is essential for optimizing patient outcomes.
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