Archive | 2021
Impact of body mass index on opioid consumption in lumbar spine fusion surgery
Abstract
Abstract BACKGROUND In the United States from 1999-2000 through 2017-2018, the prevalence of obesity increased from 30.5% to 42.4%, while the prevalence of severe obesity nearly doubled. In lumbar spine surgery, obesity is associated with increased complications, worse perioperative outcomes, and higher costs. The purpose of this study was to examine the association between body mass index (BMI) and opioid consumption in patients undergoing lumbar spine fusion surgery. We hypothesized that obese patients would require more opioids postoperatively. METHODS Retrospective review of 306 patients who underwent one- or two-level posterior lumbar interbody fusion surgery between 2016 and 2020. Patients were stratified by BMI as follows: normal weight (18.5-24.9 kg/m2), overweight (25.0–29.9 kg/m2), obese I (30.0–34.9 kg/m2), and obese II–III (≥ 35.0 kg/m2). Patient demographics and preoperative characteristics were compared across BMI cohorts using one-way ANOVA and chi-square analysis.\xa0Patients with prior history of opioid use were excluded. Primary outcome measure was postoperative opioid consumption. Secondary outcomes included operative time, length of stay (LOS), discharge destination, and 30-day readmission rates. Outcomes were analyzed using multivariable linear regression adjusted for potential confounders. RESULTS Of 306 total patients, 17.3% were normal weight, 39.9% were overweight,\xa025.5% were obese I, and 17.3% were obese II-III. Obesity was associated with longer operative times and length of stay (p CONCLUSION Obesity is associated with longer operative times, longer LOS, and increased consumption of postoperative opioids. This should be considered when counseling patients preoperatively prior to lumbar spine fusion procedures.