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776
the type of postoperative analgesic used and age categories.
All data manipulations and analyses were performed using
IBM SPSS Statistics Version 23 (SPSS Inc, Chicago,
Illinois), while graphs were constructed using Microsoft
Excel 2013 (Microsoft Corporation, Redmond, Washington).
Statistical significance was evaluated at P < .05.
Results
Sample Characteristics
A total of 19 463 patients underwent LSS between 2007 and
2014 at KU hospital. For the purpose of this study, we were
able to observe 3115 patients' medical records from 2007 to
2014. Characteristics of patient population studied are presented in Table 1. We found that greater percentage of LSS
was performed on male patients (56.1%) compared with
female patients (43.9%). Our sample primarily constituted of
Whites (84.9%) and patients of non-Hispanic origin (96.9%).
Multiple surgeries (eg, fusion and laminectomy, fusion and
discectomy, laminectomy and discectomy) were performed
at a greater rate (34.8%) compared with single surgeries.
Fusion alone (10%) was the least performed monoprocedure.
Among patients who underwent LSS, a majority (53.4%) utilized opioid alone while 41.5% used opioid in combination
with other drugs. Post LSS, 88% of the patients were discharged to home and 2.9% needed further care.
LSS Pattern and Types
Overall, we observed a rise in the number of LSS over a
period of 7 years (Figure 1). Figure 1 shows a positive trend
of all LSS performed over time from 2007 to 2014. When
data from 2007 and 2014 were compared across age categories (Figure 2), the proportion of LSSs performed slightly
increased among patients aged 65 years and above (27.3% vs
34.2%). The trend of LSSs slightly decreased among patients
aged 45 to 54 years (24.9% vs 18.3%). Table 2 shows the
proportion of each surgery type performed across various
age categories. The chi-square analysis results indicate that
the type of surgery performed was not independent of
patients' age (χ2 = 555.2, df = 8, P < .001). For example,
patients aged 55 years and above received laminectomy
more frequently compared with other surgery types, whereas
patients aged below 55 years received discectomy more frequently compared with other surgery types. While examining the proportion of individual surgery within each age
category, we noticed an increase in fusion procedure rate
over time but mainly in older population.
Hospital Pharmacy 52(11)
Table 1. Demographics and Clinical Characteristics.
Characteristics
Gender (N = 3115)
Male
Female
Race (N = 3110)a
White
Black
Asian
American Indian
Otherb
Ethnicity (N = 3014)a
Non-Hispanic
Hispanic
Discharge status (N = 3115)
Home
Further carec
Othersd
Surgery type (N = 3115)
Fusion
Laminectomy
Discectomy
Multiple surgeriese
Medications (N = 3115)
Opioid alone
Opioid combinationf
Nonopioidsg
Multiple medicationsh
n (%)
1749 (56.1)
1366 (43.9)
2639 (84.9)
253 (8.1)
14 (0.5)
7 (0.2)
197 (6.3)
2922 (96.9)
92 (3.1)
2740 (88.0)
89 (2.9)
286 (9.2)
312 (10.0)
857 (27.5)
862 (27.7)
1084 (34.8)
1663 (53.4)
1292 (41.5)
71 (2.3)
89 (2.9)
a
N is less than 3115 due to missing values.
Include 2 races and "other" race classification.
Other referral facilities (acute or chronic) other than home or self-care.
d
Other destination different from home and further care.
e
These include patients who had more than 1 type of surgery performed.
Of the 1084 patients: fusion + laminectomy (n = 724, 66.8%), fusion +
discectomy (n = 155, 14.3%), laminectomy + discectomy (n = 105, 9.7%),
and fusion + laminectomy + discectomy (n = 100, 9.2%).
f
Include opioid drugs that are in a combined dosage form with drugs such
as acetaminophen, aspirin, ibuprofen, and caffeine.
g
Include acetaminophen, aspirin, ibuprofen, and tramadol, alone or in
combination with other agents such as caffeine and butalbital.
h
These include patients who used more than 1 category of medication (eg,
opioid alone + nonopioids).
b
c
Analgesic Usage
The chi-square analysis in Table 3 shows that the type of
medication prescribed post surgery was not independent of
patients' age (χ2 = 58.6, df = 8, P < .001). For example, opioids alone were used by 55% of patients aged 55 years and
Figure 1. Trend of lumbar spine surgery from 2007 to 2014.
Table of Contents for the Digital Edition of Hospital Pharmacy - December 2017
Knowing What Is Coming: The Importance of Monitoring the Pharmaceutical Pipeline
In Reply to “Postoperative Pain Management With Liposomal Bupivacaine in Patients Undergoing Orthopedic Knee and Hip Arthroplasty at a Community Hospital”
Letter to the Editor on “Enzyme Replacement or Substrate Reduction? A Review of Gaucher Disease Treatment Options”
Response to Letter to the Editor on “Enzyme Replacement or Substrate Reduction? A Review of Gaucher Disease Treatment Options”
Commentary: Exploring Novel Approaches to Staff Rewards and Recognition
Edaravone
Pharmaceutical Pipeline Update
BACE Inhibitors and Tau Protein Targeting Drugs in Prevention of Alzheimer’s Disease
Direct and Indirect Remuneration Fees: The Controversy Continues
Factors Associated With Burnout Among US Hospital Clinical Pharmacy Practitioners: Results of a Nationwide Pilot Survey
In Vitro Evaluation of Eslicarbazepine Delivery via Enteral Feeding Tubes
Evaluation of Insulin Use and Hypoglycemia in Hospitalized Elderly Patients
Production Standard and Stability of Compounded del Nido Cardioplegia Solution
Lumbar Spine Surgeries and Medication Usage During Hospital Stay: One-Center Perspective
Hospital Pharmacy - December 2017 - 713
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Hospital Pharmacy - December 2017 - Knowing What Is Coming: The Importance of Monitoring the Pharmaceutical Pipeline
Hospital Pharmacy - December 2017 - 722
Hospital Pharmacy - December 2017 - In Reply to “Postoperative Pain Management With Liposomal Bupivacaine in Patients Undergoing Orthopedic Knee and Hip Arthroplasty at a Community Hospital”
Hospital Pharmacy - December 2017 - 724
Hospital Pharmacy - December 2017 - Letter to the Editor on “Enzyme Replacement or Substrate Reduction? A Review of Gaucher Disease Treatment Options”
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Hospital Pharmacy - December 2017 - Response to Letter to the Editor on “Enzyme Replacement or Substrate Reduction? A Review of Gaucher Disease Treatment Options”
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Hospital Pharmacy - December 2017 - Commentary: Exploring Novel Approaches to Staff Rewards and Recognition
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Hospital Pharmacy - December 2017 - Direct and Indirect Remuneration Fees: The Controversy Continues
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Hospital Pharmacy - December 2017 - Factors Associated With Burnout Among US Hospital Clinical Pharmacy Practitioners: Results of a Nationwide Pilot Survey
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