Abstract 335: Distinguishing Cardiac From Non-Cardiac Causes of Sudden Death: The Value of Novel Factors to Identify Risk of SCD

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Katherine S Allan ◽  
Theresa Aves ◽  
Arnold Pinter ◽  
Laurie Morrison ◽  
Paul Dorian
Keyword(s):  
Chest Pain ◽  
Public Awareness ◽  
Acute Infection ◽  
Signs And Symptoms ◽  
Factors Associated ◽  
Greater Toronto Area ◽  
Younger Age ◽  
Increased Risk ◽  
Future Events ◽  
Male Sex

Introduction: Identifying those at risk for Sudden Cardiac Death (SCD) is imperative to prevent future events. There may be risk factors (RFs), triggers or warning symptoms preceding the SCD that could help identify those at greatest risk. Methods: This retrospective study included out-of-hospital cardiac arrests (OHCAs) of “no obvious cause” in the Greater Toronto Area, ages 2-45 from 2009-2012. Expert reviewers systematically adjudicated EMS, coroner, autopsy, toxicology and police reports to classify the etiology of arrest as SCD or SD due to non-cardiac etiologies (non-cardiac SDs). We compared past medical history, triggers and symptoms in the adjudicated SCD and non-cardiac SD groups and assessed their potential associations with SCD. Results: 872 OHCAs were classified as SCDs (488; 56%) or non-cardiac SDs (384; 44%). The SCDs were mostly CAD (203; 41.6%), structural (155; 31.8%), congenital (8; 1.6%) and primary arrhythmic (76; 15.6%). The non-cardiac SDs were due to acute infection (67; 17.4%), metabolic (75, 19.5%), epilepsy (69, 18.0%), vascular (106; 27.6%) and respiratory (35, 9.1%). Cardiac RFs and exercise as a trigger were observed significantly more in SCDs vs. non-cardiac SDs (Table 1). Symptoms ≤24 hours prior were similar between groups except for chest pain and diaphoresis. After adjusting for patient and resuscitation variables, factors associated with increased risk of SCD were: increasing age (OR 1.03; 95%CI 1.01-1.05), male sex (OR 1.90; 95%CI 1.30-2.70), HTN (OR 1.80; 95%CI 1.11-3.10), smoking (1.60; 95%CI 1.02-2.60), public location (OR 2.10; 95%CI 1.13-3.80), exercise (OR 3.0 95%CI 1.56-5.59) and chest pain ≤24 hours prior (OR 2.90 95%CI 1.30-6.42). Conclusion: Many young SCDs have previously diagnosed cardiac RFs and acute symptoms suggestive of ischemia prior to their event. These findings highlight the potential value of better public awareness in the younger age group for signs and symptoms of ischemia and potential risk for SCD.

Long-term mortality rates and associated risk factors following primary and revision knee arthroplasty

2022 ◽  
Vol 104-B (1) ◽  
pp. 45-52
Author(s):  
Liam Zen Yapp ◽  
Nick D. Clement ◽  
Matthew Moran ◽  
Jon V. Clarke ◽  
A. Hamish R. W. Simpson ◽  
...  
Keyword(s):  
General Population ◽  
Knee Arthroplasty ◽  
Mortality Rates ◽  
Factors Associated ◽  
Revision Knee Arthroplasty ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Male Sex ◽  
Long Term Mortality

Aims The aim of this study was to determine the long-term mortality rate, and to identify factors associated with this, following primary and revision knee arthroplasty (KA). Methods Data from the Scottish Arthroplasty Project (1998 to 2019) were retrospectively analyzed. Patient mortality data were linked from the National Records of Scotland. Analyses were performed separately for the primary and revised KA cohorts. The standardized mortality ratio (SMR) with 95% confidence intervals (CIs) was calculated for the population at risk. Multivariable Cox proportional hazards were used to identify predictors and estimate relative mortality risks. Results At a median 7.4 years (interquartile range (IQR) 4.0 to 11.6) follow-up, 27.8% of primary (n = 27,474/98,778) and 31.3% of revision (n = 2,611/8,343) KA patients had died. Both primary and revision cohorts had lower mortality rates than the general population (SMR 0.74 (95% CI 0.73 to 0.74); p < 0.001; SMR 0.83 (95% CI 0.80 to 0.86); p < 0.001, respectively), which persisted for 12 and eighteight years after surgery, respectively. Factors associated with increased risk of mortality after primary KA included male sex (hazard ratio (HR) 1.40 (95% CI 1.36 to 1.45)), increasing socioeconomic deprivation (HR 1.43 (95% CI 1.36 to 1.50)), inflammatory polyarthropathy (HR 1.79 (95% CI 1.68 to 1.90)), greater number of comorbidities (HR 1.59 (95% CI 1.51 to 1.68)), and periprosthetic joint infection (PJI) requiring revision (HR 1.92 (95% CI 1.57 to 2.36)) when adjusting for age. Similarly, male sex (HR 1.36 (95% CI 1.24 to 1.49)), increasing socioeconomic deprivation (HR 1.31 (95% CI 1.12 to 1.52)), inflammatory polyarthropathy (HR 1.24 (95% CI 1.12 to 1.37)), greater number of comorbidities (HR 1.64 (95% CI 1.33 to 2.01)), and revision for PJI (HR 1.35 (95% 1.18 to 1.55)) were independently associated with an increased risk of mortality following revision KA when adjusting for age. Conclusion The SMR of patients undergoing primary and revision KA was lower than that of the general population and remained so for several years post-surgery. However, approximately one in four patients undergoing primary and one in three patients undergoing revision KA died within tenten years of surgery. Several patient and surgical factors, including PJI, were associated with the risk of mortality within ten years of primary and revision surgery. Cite this article: Bone Joint J 2022;104-B(1):45–52.

scholarly journals Behavioral Factors Associated with Medication Nonadherence in Patients with Hypertension

2021 ◽  
Vol 18 (18) ◽  
pp. 9614
Author(s):  
Shu-Mei Chang ◽  
I-Cheng Lu ◽  
Yi-Chun Chen ◽  
Chin-Feng Hsuan ◽  
Yin-Jin Lin ◽  
...  
Keyword(s):  
Protective Factor ◽  
Multivariable Logistic Regression Analysis ◽  
Behavioral Factors ◽  
Medication Nonadherence ◽  
Hypertensive Patients ◽  
Factors Associated ◽  
Diet Supplements ◽  
Increased Risk ◽  
Medication Dose ◽  
Male Sex

Medication nonadherence is associated with an increased risk of complications in hypertensive patients. We investigated behavioral factors associated with medication nonadherence in hypertensive patients in southern Taiwan. Using questionnaires, we collected data regarding clinicodemographic characteristics and nonadherence behaviors from 238 hypertensive patients. We assessed the self-reported prevalence of specific behaviors of medication nonadherence and investigated factors associated with each behavior using multivariable logistic regression analysis. The most common behavior of medication nonadherence was forgetting to take medication (28.6%), followed by discontinuing medication (9.2%) and reducing the medication dose (8.8%). Age ≥ 65 years (adjusted odds ratio [aOR] = 0.32, 95% confidence interval [CI] = 0.15–0.69) and male sex (aOR = 2.61, CI = 1.31–5.19) were associated with forgetting to take medication. The presence of comorbidities (diabetes, kidney disease, or both) and insomnia (aOR = 3.97, 95% CI = 1.30–12.1) was associated with reducing the medication dose. The use of diet supplements was associated with discontinuing the medication (aOR = 4.82, 95% CI = 1.50–15.5). Compliance with a low oil/sugar/sodium diet was a protective factor against discontinuing medication (aOR = 0.14; 95% CI = 0.03–0.75). The most pervasive behavior associated with medication nonadherence among hypertensive patients was forgetting to take medication. Age <65 years, male sex, comorbidities, insomnia, noncompliance with diet, and the use of dietary supplements were specifically associated with medication nonadherence.

scholarly journals Identifying Risk Factors Associated with Inappropriate Use of Acid Suppressive Therapy at a Community Hospital

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Amandeep Singh ◽  
Vijay Bodukam ◽  
Kirit Saigal ◽  
Jaya Bahl ◽  
Yvette Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Stress Ulcer ◽  
Prescribing Patterns ◽  
Suppressive Therapy ◽  
Factors Associated ◽  
Inappropriate Use ◽  
Younger Age ◽  
Increased Risk ◽  
Ulcer Prophylaxis ◽  
Patient At Risk

Purpose. By examining the prescribing patterns and inappropriate use of acid suppressive therapy (AST) during hospitalization and at discharge we sought to identify the risk factors associated with such practices.Methods. In this retrospective observational study, inpatient records were reviewed from January 2011 to December 2013. Treatment with AST was considered appropriate if the patient had a known specific indication or met criteria for stress ulcer prophylaxis.Results. In 2011, out of 58 patients who were on AST on admission, 32 were newly started on it and 23 (72%) were inappropriate cases. In 2012, out of 97 patients on AST, 61 were newly started on it and 51 (84%) were inappropriate cases. In 2013, 99 patients were on AST, of which 48 were newly started on it and 36 (75%) were inappropriate cases. 19% of the patients inappropriately started on AST were discharged on it in three years. Younger age, female sex, and 1 or more handoffs between services were significantly associated with increased risk of inappropriate AST.Conclusion. Our findings reflect inappropriate prescription of AST which leads to increase in costs of care and unnecessarily puts the patient at risk for potential adverse events. The results of this study emphasize the importance of examining the patient’s need for AST at each level of care especially when the identified risk factors are present.

scholarly journals Treatment Outcomes Among Older Human Immunodeficiency Virus-Infected Adults in Nigeria

2017 ◽  
Vol 4 (2) ◽  
Author(s):  
Patricia A. Agaba ◽  
Seema T. Meloni ◽  
Halima M. Sule ◽  
Oche O. Agbaji ◽  
Atiene S. Sagay ◽  
...  
Keyword(s):  
Older Patients ◽  
Viral Suppression ◽  
Older Age ◽  
University Teaching ◽  
World Health ◽  
Stage Iii ◽  
Hazard Models ◽  
Factors Associated ◽  
Increased Risk ◽  
Male Sex

Abstract Background Older age at initiation of combination antiretroviral therapy (cART) has been associated with poorer clinical outcomes. Our objectives were to compare outcomes between older and younger patients in our clinical cohort in Jos, Nigeria. Methods This retrospective cohort study evaluated patients enrolled on cART at the Jos University Teaching Hospital, Nigeria between 2004 and 2012. We compared baseline and treatment differences between older (≥50 years) and younger (15–49 years) patients. Kaplan-Meier analysis and Cox proportional hazard models estimated survival and loss to follow-up (LTFU) and determined factors associated with these outcomes at 24 months. Results Of 8352 patients, 643 (7.7%) were aged ≥50 years. The median change in CD4 count from baseline was 151 vs 132 (P = .0005) at 12 months and 185 vs 151 cells/mm3 (P = .03) at 24 months for younger and older patients, respectively. A total of 68.9% vs 71.6% (P = .13) and 69.6% vs 74.8% (P = .005) of younger and older patients achieved viral suppression at 12 and 24 months, with similar incidence of mortality and LTFU. In adjusted hazard models, factors associated with increased risk of mortality were male sex, World Health Organization (WHO) stage III/IV, and having a gap in care, whereas being fully suppressed was protective. The risk of being LTFU was lower for older patients, those fully suppressed virologically and with adherence rates &gt;95%. Male sex, lack of education, WHO stage III/IV, body mass index &lt;18.5 kg/m2, and having a gap in care independently predicted LTFU. Conclusions Older patients achieved better viral suppression, and older age was not associated with increased mortality or LTFU in this study.

Risk factors associated with suicide in patients with prostate cancer in the United States.

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 84-84
Author(s):  
Manojna Konda ◽  
Rohan Sharma ◽  
Arya Mariam Roy ◽  
Rashmi Verma
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Health Care Providers ◽  
The United States ◽  
Care Providers ◽  
Suicide Death ◽  
Factors Associated ◽  
Younger Age ◽  
Increased Risk ◽  
Caucasian Race

84 Background: For a patient, receiving a diagnosis of cancer can be quite challenging and is often associated with depression and increased suicidal ideation. Previous studies have indicated that the risk of suicide in cancer patients is twice that of general population. Prostate cancer is the most common cancer in men. It has also been found to be associated with highest rates of suicide in genitourinary malignancies. We sought to evaluate the incidence and identify risk factors associated with suicide among men with prostate cancer. Methods: Patients with prostate cancer between the years 1973 and 2016 were identified in the Surveillance, Epidemiology, and End Results database (SEER). Multivariate logistic regression analysis was performed to identify independent risk factors for suicide death only on variables that were statistically significant in univariate statistical analysis. Results: In 1,307,625 patients with prostate cancer, 3,435 patients had committed suicide. Younger age (≤50 vs > 70: OR = 4.73 , P < 0.0001; 51-70 vs > 70: OR = 1.93, P < 0.04), Caucasian race (OR: 3.61, P < 0.0001) and not undergoing surgery (OR: 1.33, P < 0.0001) were significantly associated with increased risk of suicide. Furthermore, patients with < 1 year since the diagnosis of prostate cancer were also found to be associated with increased risk of suicide death ( < 1 vs > 5 years: OR = 1.46, P < 0.0001). Conclusions: Addressing mental health in patients with prostate cancer is an important issue. We found that several factors such as younger age, Caucasian race were significantly associated with risk of suicide. Patients who did not undergo surgery likely had advanced disease, which could explain their increased risk of suicide. Patients with < 1 year since the diagnosis of prostate cancer are more vulnerable and at increased risk of suicide which emphasizes the necessity of identifying and treating patients at risk of suicide as early as possible. It is vital that health care providers recognize these patients and offer them appropriate support.

scholarly journals Iron deficiency in healthy 18-month-old Danish children is associated with no oral iron supplementation in infancy and prolonged exclusive breast-feeding

2019 ◽  
Vol 122 (12) ◽  
pp. 1409-1416
Author(s):  
Anh Thao N. Andersen ◽  
Steffen Husby ◽  
Henriette B. Kyhl ◽  
Maria B. Sandberg ◽  
Stine D. Sander ◽  
...  
Keyword(s):  
Birth Cohort ◽  
Breast Feeding ◽  
Maternal Education ◽  
Acute Infection ◽  
C Reactive Protein ◽  
Exclusive Breast Feeding ◽  
Factors Associated ◽  
Reactive Protein ◽  
Increased Risk ◽  
Longitudinal Association

AbstractFe deficiency (ID) defined as plasma ferritin <12 µg/l is associated with delayed cognitive development in early childhood and increased incidence of infections; however, the longitudinal association between early-life factors and ID in 18-month-old children in Denmark is unknown. The present study aimed to determine the prevalence of ID and to describe risk factors associated with ID in healthy 18-month-old Danish children. Blood samples, anthropometric measurements and self-reported questionnaire data had been obtained in the birth cohort, Odense Child Cohort. The questionnaires were modified from those used in the Danish National Birth Cohort. Plasma ferritin and C-reactive protein in venous, non-fasting samples were analysed in the final sample size of 370 children after exclusion of seventy-nine children due to chronic disease, acute infection, C-reactive protein >10 mg/l, twin birth or prematurity. Associations with ID were analysed by logistic regression, adjusting for sex, maternal education, duration of partial breast-feeding and current intake of milk, fish and meat. Overall, fifty-six children had ID (15·1 %). Factors associated with increased risk were exclusive breast-feeding beyond 4 months (OR 5·97; 95 % CI 1·63, 21·86) and no intake of oral Fe supplements from 6 to 12 months (OR 3·99, 95 % CI 1·33, 11·97. Duration of partial breast-feeding and current diet was not associated with ID. In conclusion, the ID prevalence was 15·1 %, and both exclusive breast-feeding beyond 4 months and no intake of oral Fe supplements from 6 to 12 months were associated with increased risk of ID in 18-month-old children.

scholarly journals Factors associated with thrombocytopenia in patients with dengue fever: a retrospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e035120
Author(s):  
Bruna M Castilho ◽  
Marcus T Silva ◽  
André R R Freitas ◽  
Izabela Fulone ◽  
Luciane Cruz Lopes
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Dengue Fever ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Dengue Infection ◽  
Factors Associated ◽  
Increased Risk ◽  
Haematological Changes ◽  
Male Sex

ObjectiveSome patients with dengue fever tend to develop thrombocytopenia during the course of infection and are thus vulnerable to haemorrhagic manifestations and other complications. However, the factors associated with the development of thrombocytopenia are unknown. We aimed to identify factors associated with an increased risk of thrombocytopenia and haematological changes in patients with confirmed dengue fever.DesignRetrospective cohort study.SettingBrazilian multicentre primary care databases.Participants387 patients had positive laboratory serological confirmation of dengue infection during 2014. The data were identified from two databases: Notification of Injury Information System (SINAN) and Municipal Laboratory.Main outcome measureThe presence of thrombocytopenia (platelet count <1 50×109/L). The associations of factors that predisposed patients to thrombocytopenia and haematological changes were analysed using logistic regression. ORs and 95% CIs were calculated.ResultsAmong 387 patients, 156 had both dengue and thrombocytopenia. The risk factors associated with thrombocytopenia included male sex (OR: 1.77, 95% CI: 1.16 to 2.71, p=0.007), age of 46–64 years (OR: 2.20, 95% CI: 1.15 to 4.21, p=0.009) or ≥65 years (OR: 3.02, 95% CI: 1.40 to 6.50, p=0.002), presence of leucopenia (OR: 6.85, 95% CI: 4.27 to 10.99, p<0.001) and high mean corpuscular haemoglobin (MCH) levels (OR: 2.00, 95% CI: 1.29 to 3.12, p=0.005).ConclusionOlder age, male sex, presence of leucopenia and high MCH levels were identified as risk factors associated with the development of thrombocytopenia in this population.

Symptomatic Venous Thromboembolism After Achilles Tendon Rupture: A Nationwide Danish Cohort Study of 28,546 Patients With Achilles Tendon Rupture

2019 ◽  
Vol 47 (13) ◽  
pp. 3229-3237 ◽  
Author(s):  
Melissa Hornbæk Pedersen ◽  
Liv Riisager Wahlsten ◽  
Henrik Grønborg ◽  
Gunnar Hilmar Gislason ◽  
Michael Mørk Petersen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Nonoperative Treatment ◽  
Incidence Rates ◽  
Factors Associated ◽  
Increased Risk ◽  
Male Sex

Background: Venous thromboembolism (VTE) is a well-known complication of Achilles tendon rupture (ATR) and carries a high risk of morbidity and mortality. Although routine thromboprophylaxis for patients with ATR is not recommended, sparse knowledge is available regarding risk factors associated with VTE in patients with ATR. Purpose: To use Danish nationwide registers to identify incidence rates for symptomatic VTE and risk factors associated with increased risk of developing VTE in patients with ATR. Study Design: Cohort study; Level of evidence, 3. Methods: By crosslinking nationwide registers, we identified all patients with diagnosed ATR in Denmark from 1997 to 2015. We stratified patients into 4 groups by age and treatment modality (ie, operative vs nonoperative treatment). The main outcome was VTE within 180 days. We calculated crude incidence rates and considered age, sex, year, comorbidities, and medications as risk factors for VTE in Poisson regression models. Results: We identified 28,546 patients with ATR, of whom 389 (1.36%) were hospitalized with VTE during the follow-up period: 278 due to deep vein thromboses and 138 due to pulmonary embolism. Incidence rates were highest during the first month and ranged from 4.6 to 14.6 events per 100 person-years. VTEs were most frequent among nonoperatively treated patients aged ≥50 years. In Poisson regression analyses, having had VTE beforehand was associated with an increased risk of VTE, as was male sex in the nonoperative treatment group aged ≥50 years; among women <50 years of age, hormonal contraceptives led to a 4- to 6-fold higher risk of VTE compared with patients in the same group without the equivalent risk factor. Conclusion: In this nationwide cohort of patients with ATR, 1.36% developed symptomatic VTE during follow-up. Hormonal contraception, previous VTE, older age group, and male sex increased the risk of VTE. Taken together, the results of the present study suggest that focus on risk stratification and initiatives to prevent VTE might be warranted. A randomized controlled trial could answer this question.

scholarly journals Mental health and substance use associated with hospitalization among people with laboratory confirmed diagnosis of COVID-19 in British Columbia: a population-based cohort study

2021 ◽  
Author(s):  
Héctor Alexander Velásquez García ◽  
James Wilton ◽  
Kate Smolina ◽  
Mei Chong ◽  
Drona Rasali ◽  
...  
Keyword(s):  
British Columbia ◽  
Substance Use ◽  
Hospital Admission ◽  
Prescription Drugs ◽  
Older Age ◽  
Reproductive Age ◽  
Adjusted Risk ◽  
Factors Associated ◽  
Increased Risk ◽  
Male Sex

Background: This study identified factors associated with hospital admission among people with laboratory-diagnosed COVID-19 cases in British Columbia. Methods: This study was performed using the BC COVID-19 Cohort, which integrates data on all COVID-19 cases, hospitalizations, medical visits, emergency room visits, prescription drugs, chronic conditions and deaths. The analysis included all laboratory-diagnosed COVID-19 cases in British Columbia as of January 15th, 2021. We evaluated factors associated with hospital admission using multivariable Poisson regression analysis with robust error variance. Findings: From 56,874 COVID-19 cases included in the analyses, 2,298 were hospitalized. Models showed significant association of the following factors with increased hospitalization risk: male sex (adjusted risk ratio (aRR)=1.27; 95%CI=1.17-1.37), older age (p-trend <0.0001 across age groups with a graded increase in hospitalization risk with increasing age [aRR 30-39 years=3.06; 95%CI=2.32-4.03, to aRR 80+years=43.68; 95%CI=33.41-57.10 compared to 20-29 years-old]), asthma (aRR=1.15; 95%CI=1.04-1.26), cancer (aRR=1.19; 95%CI=1.09-1.29), chronic kidney disease (aRR=1.32; 95%CI=1.19-1.47), diabetes (treated without insulin aRR=1.13; 95%CI=1.03-1.25, requiring insulin aRR=5.05; 95%CI=4.43-5.76), hypertension (aRR=1.19; 95%CI=1.08-1.31), injection drug use (aRR=2.51; 95%CI=2.14-2.95), intellectual and developmental disabilities (aRR=1.67; 95%CI=1.05-2.66), problematic alcohol use (aRR=1.63; 95%CI=1.43-1.85), immunosuppression (aRR=1.29; 95%CI=1.09-1.53), and schizophrenia and psychotic disorders (aRR=1.49; 95%CI=1.23-1.82). Among women of reproductive age, in addition to age and comorbidities, pregnancy (aRR=2.69; 95%CI=1.42-5.07) was associated with increased risk of hospital admission. Interpretation: Older age, male sex, substance use, intellectual and developmental disability, chronic comorbidities, and pregnancy increase the risk of COVID-19-related hospitalization. Funding: BC Centre for Disease Control, Canadian Institutes of Health Research.

scholarly journals Factors predicting opioid dependence in patients undergoing surgery for degenerative spondylolisthesis: analysis from the MarketScan databases

2018 ◽  
Vol 29 (3) ◽  
pp. 271-278 ◽  
Author(s):  
Mayur Sharma ◽  
Beatrice Ugiliweneza ◽  
Zaid Aljuboori ◽  
Miriam A. Nuño ◽  
Doniel Drazin ◽  
...  
Keyword(s):  
Regression Models ◽  
Opioid Dependence ◽  
Degenerative Spondylolisthesis ◽  
The United States ◽  
Opioid Use ◽  
Factors Affecting ◽  
Factors Associated ◽  
Younger Age ◽  
Increased Risk ◽  
National Emergency

OBJECTIVEThe opioid crisis is identified as a national emergency and epidemic in the United States. The aim of this study was to identify risk factors associated with opioid dependence in patients undergoing surgery for degenerative spondylolisthesis (DS).METHODSThe authors queried MarketScan databases to investigate the factors affecting postsurgery opioid use in patients with DS between 2000 and 2012. The outcome of interest was opioid dependence, which was defined as continued opioid use, > 10 opioid prescriptions, or diagnosis of or prescription for opioid dependence disorder in the period of 1 year before or 3–15 months after the procedure. Comparisons of outcomes were performed using nonparametric 2-group tests and generalized regression models.RESULTSA cohort of 10,708 patients was identified from the database. The median patient age was 61 years (interquartile range 54–69 years), and 65.1% were female (n = 6975). A majority of patients had decompression with fusion (n = 10,068; 94%) and underwent multilevel procedures (n = 8123; 75.9%). Of 10,708 patients, 14.85% (n = 1591) were identified as having opioid dependence within 12 months prior to the index surgical procedure and 9.90% (n = 1060) were identified as having opioid dependence within 3–15 months after the procedure. Of all the variables, prior opioid dependence (OR 16.29, 95% CI 14.10–18.81, p < 0.001) and younger age (1-year increase in age: OR 0.972, 95% CI 0.963–0.980, p < 0.001) were independent predictors of opioid dependence following surgery for DS. The use of fusion was not associated with opioid dependence following the procedure (p = 0.8396). Following surgery for DS, patients were more likely to become opioid independent than they were to become opioid dependent (8.54% vs 3.58%, p < 0.001).CONCLUSIONSThe majority of patients underwent fusion for DS. Surgical decompression with fusion was not associated with increased risk of postsurgery opioid dependence in patients with DS. Overall, opioid dependence was reduced by 4.96% after surgery for DS. Prior opioid dependence is associated with increased risk and increasing age is associated with decreased risk of opioid dependence following surgery for DS.

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