Association of Opioid Use Disorder on Postoperative Outcomes Following Lumbar Laminectomy: A Nationwide Retrospective Analysis of the Medicare Population

Article Figures & Data

Table 1

Baseline demographics of patients with opioid use disorder and comparison cohort undergoing lumbar spine laminectomy.

Demographics	Opioid Use Disorder		Comparison Cohort		P Value
Demographics	n	%	n	%	P Value
Age, y					<0.0001
<64	1977	56.24	14,522	11.33
65–69	686	19.52	34,910	27.25
70–74	409	11.64	32,494	25.36
75–79	252	7.17	25,603	19.98
80–84	138	3.93	14,680	11.46
>85	53	1.51	5911	4.61
Sex					<0.0001
Female	2011	57.21	62,253	48.59
Male	1504	42.79	65,867	51.41
Comorbidities
Alcohol use disorder	772	21.96	5368	4.19	<0.0001
Arrhythmias	1607	45.72	48,035	37.49	<0.0001
BMI 19–24 kg/m²	128	3.64	2023	1.58	<0.0001
BMI 25–29 kg/m²	214	6.09	4277	3.34	<0.0001
BMI 30–39 kg/m²	614	17.47	12,646	9.87	<0.0001
BMI 40–70 kg/m²	296	8.42	4322	3.37	<0.0001
Congestive heart failure	1081	30.75	27,085	21.14	<0.0001
Coagulopathy	668	19.00	16,026	12.51	<0.0001
Depressive disorders	2699	76.79	40,359	31.50	<0.0001
Diabetes mellitus	1729	49.19	52,110	40.67	<0.0001
Hypertension	3172	90.24	114,339	89.24	0.001
Hypothyroidism	1374	39.09	40,344	31.49	<0.0001
Iron deficiency anemia	2184	62.13	54,887	42.84	<0.0001
Liver failure	802	22.82	10,566	8.25	<0.0001
Neurological deficits	869	24.72	17,268	13.48	<0.0001
Peptic ulcer disease	649	18.46	12,160	9.49	<0.0001
Peripheral vascular disease	1455	41.39	46,191	36.05	<0.0001
Renal failure	340	9.67	7562	5.90	<0.0001
Rheumatoid arthritis	1466	41.71	26,868	20.97	<0.0001
Valvular disorders	1157	32.92	33,986	26.53	<0.0001
Pathologic weight loss	449	12.77	6939	5.42	<0.0001
Elixhauser Comorbidity Index, mean	9		4		<0.0001

Table 2

Comparison of 90-d medical complications between opioid use disorder and comparison cohort following primary lumbar spine laminectomy.

Medical Complications Assessed	Opioid Use Disorder, %	Comparison, %	OR	95% CI	P Value^a
Pneumonia	6.29	1.23	5.23	3.57–5.99	<0.0001
Transfusion of blood products	0.54	0.15	5.12	2.92–8.48	<0.0001
Respiratory failure	0.54	0.12	4.07	2.29–6.87	<0.0001
Urinary tract infection	14.54	4.49	3.57	3.19–3.97	<0.0001
Acute kidney injuries	4.84	1.36	3.31	2.75–3.95	<0.0001
Cerebrovascular accidents	1.74	0.55	3.26	2.42–4.33	<0.0001
Deep vein thromboses	1.48	0.70	2.21	1.61–2.97	<0.0001
Myocardial infarctions	0.77	0.30	2.20	1.40–3.32	<0.0001
Venous thromboemboli	1.62	0.86	2.02	1.50–2.67	0.018
Total medical complications	32.36	9.76	3.53	3.23–3.85	<0.0001

aAdjusted for age, sex, geographic region, alcohol use disorder, chronic obstructive pulmonary disease, diabetes mellitus, general anxiety disorder, hyperlipidemia, hypertension, obesity, and tobacco use.