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

Abstract

BACKGROUND CONTEXT Long-term opioid use is common among ASD patients, and it is a cause of significant morbidity. PURPOSE 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. STUDY DESIGN/SETTING Retrospective cohort study. PATIENT SAMPLE 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. OUTCOME MEASURES Self-reported opioid use at 2-year follow-up. METHODS 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-naive 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. RESULTS 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-naive. 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 CONCLUSIONS 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 reporting preoperative opioid use have consistently higher rates of opioid use at a given time point compared to opioid-naive patients. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.