title: Impact of the combined use of opioids and surgical procedures on workers' compensation cost among a cohort of injured workers in the state of Louisiana.
abstract: OBJECTIVE
  To determine the impact of surgical procedures and opioids on workers' compensation claim cost.
  
  
  METHODS
  A cohort of 11,394 lost time claims filed with the Louisiana Workers' Compensation Corporation from 1999 to 2002 was followed for 7 years.
  
  
  RESULTS
  Controlling for gender, attorney involvement, and claim duration, multivariate logistic regression analysis indicated that odds ratios (ORs) for a catastrophic claim (final cost ≥ $100,000) associated with short-acting and long-acting opioids (vs no opioids) were 4.28 and 12.19. The ORs for catastrophic claims associated with a spinal surgical procedure or spinal fusion (vs no procedure) were 4.27 and 11.40. Spinal surgical procedures plus opioid use significantly increased the OR for catastrophic claims; for example, spinal fusion plus long-acting opioids had an OR of 138.96.
  
  
  CONCLUSIONS
  Spinal surgery and opioid utilization are associated with catastrophic claim costs.
authors.affiliation: Division of Occupational and Environmental Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md 21287, USA.
authors.forename: Xuguang Grant
authors.initials: XG
authors.lastname: Tao
authors.forename: Robert A
authors.initials: RA
authors.lastname: Lavin
authors.forename: Larry
authors.initials: L
authors.lastname: Yuspeh
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Bernacki
mesh_terms: D000701:Analgesics, Opioid / Q000191:economics* / Q000627:therapeutic use; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000191:economics; D005260:Female; D006801:Humans; D016015:Logistic Models; D008145:Louisiana; D008297:Male; D015999:Multivariate Analysis; D060051:Occupational Injuries / Q000188:drug therapy / Q000191:economics* / Q000601:surgery; D016017:Odds Ratio; D013123:Spinal Fusion / Q000191:economics; D013514:Surgical Procedures, Operative / Q000191:economics*; D014942:Workers' Compensation / Q000191:economics*
chemical_list: D000701:Analgesics, Opioid