title: Interaction of age and opioid dependence on length of hospital stay for spine surgery patients.
abstract: Clinical information suggests that opioid dependence is a major contributor to poor outcomes involving health status and to increased length of stay in hospital settings. Before spine surgery, 150 patients who were using an opioid medication for pain relief were interviewed using the six World Health Organization (WHO) guidelines for the diagnosis of opioid dependence. Three groups were defined: opioid-dependent, nonopioid-dependent, and a subclinical group. Results revealed an average of 20% of patients (N = 30) who met the WHO criteria for the diagnosis of opioid dependence. There were significant positive correlations between age and number of positive WHO criteria, length of stay, and time under surgery. Length of stay was significantly higher for the older age group (> 55 yr.). ANCOVA analysis using two opioid dependence groups (+ and -) and age group as independent variables affecting length of stay, after controlling for type of surgery, pain intensity, and number of previous spine surgeries, revealed that effects of opioid dependence status and age were significant but their interaction was not. Age did add length of stay independently of opioid dependence status; older adults remain in the hospital longer for various reasons probably associated with comorbidities.
authors.affiliation: Georgia Neurosurgical Institute, Macon, GA 31201, USA. leehyer@ganeurosurg.org
authors.forename: Leon A
authors.initials: LA
authors.lastname: Hyer
authors.forename: M Sami
authors.initials: MS
authors.lastname: Walid
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Brooks
authors.forename: Dana M
authors.initials: DM
authors.lastname: Darmohray
authors.forename: Joe Sam
authors.initials: JS
authors.lastname: Robinson
mesh_terms: D000367:Age Factors; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D001416:Back Pain / Q000188:drug therapy*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D010147:Pain Measurement / Q000187:drug effects; D012086:Reoperation; D013122:Spinal Diseases / Q000453:epidemiology / Q000601:surgery*; D013223:Statistics as Topic
chemical_list: D000701:Analgesics, Opioid