Factors affecting lumbar surgery outcome: A nation-wide, population-based retrospective study

Vincent Chin-Hung Chen, Yao Hsu Yang, Pin Yuan Chen, Jen Tsung Yang, Carl P.C. Chen, Chi Jen Chen, Mong Liang Lu, Yena Lee, Roger S. McIntyre, Yin Cheng Huang

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background Lower back pain is a very common symptom and treatment strategies vary according the severity and duration of illness. Surgical approaches are becoming increasingly popular with the advent of new and less invasive technologies; however, treatment outcomes are not yet well established on a population-based level. Taiwan's National Health Insurance Research Database (NHIRD) is longitudinal and includes 98% of the population since its inception in 1995. The database includes the ICD 9.0 codes (International Classification of Diseases) of all patients with lower back pain and lumbar surgery; furthermore, all the prescriptions. Methods As part of a population-based cohort study of one million participants randomly selected from the NHIRD, we analyzed changes in prescription of analgesics 1 year before and 1 year after lumbar surgery; comorbidities, such as diabetes, asthma, osteoporosis, arthritis, depression and anxiety were also analyzed as covariates. A total of 3916 cases were enrolled in final analysis. Results Post-operatively, the defined daily dosage (DDD) of analgesics decreased from a median DDD of 50.0 to a median of 14.2. In a multivariate model analysis, female, older age, anxiety and asthma were the significant factors for unfavorable outcome (defined by dosage of analgesics decreased less than 50% after surgery). Conclusions The analgesics significantly decreased for patients received lumbar surgeries, implying the decreased of pain. In addition, co-morbidity factors were identified by the failure for analgesics reduction, such as female, older age, anxiety and asthma. For patients with lower back pain, these factors should be considered before receiving lumbar surgeries.

Original languageEnglish
Pages (from-to)98-102
Number of pages5
JournalJournal of Affective Disorders
Volume222
DOIs
Publication statusPublished - Nov 1 2017

Fingerprint

Analgesics
Retrospective Studies
Low Back Pain
Asthma
Anxiety
Population
National Health Programs
Databases
Prescriptions
International Classification of Diseases
Taiwan
Research
Osteoporosis
Arthritis
Comorbidity
Cohort Studies
Multivariate Analysis
Depression
Technology
Morbidity

Keywords

  • Analgesics
  • Comorbidity factor
  • Defined daily dose
  • Lower back pain
  • Lumbar surgery
  • Non-steroid anti-inflammatory drug
  • Prognosis

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Chin-Hung Chen, V., Yang, Y. H., Chen, P. Y., Yang, J. T., Chen, C. P. C., Chen, C. J., ... Huang, Y. C. (2017). Factors affecting lumbar surgery outcome: A nation-wide, population-based retrospective study. Journal of Affective Disorders, 222, 98-102. https://doi.org/10.1016/j.jad.2017.06.060

Factors affecting lumbar surgery outcome : A nation-wide, population-based retrospective study. / Chin-Hung Chen, Vincent; Yang, Yao Hsu; Chen, Pin Yuan; Yang, Jen Tsung; Chen, Carl P.C.; Chen, Chi Jen; Lu, Mong Liang; Lee, Yena; McIntyre, Roger S.; Huang, Yin Cheng.

In: Journal of Affective Disorders, Vol. 222, 01.11.2017, p. 98-102.

Research output: Contribution to journalArticle

Chin-Hung Chen, V, Yang, YH, Chen, PY, Yang, JT, Chen, CPC, Chen, CJ, Lu, ML, Lee, Y, McIntyre, RS & Huang, YC 2017, 'Factors affecting lumbar surgery outcome: A nation-wide, population-based retrospective study', Journal of Affective Disorders, vol. 222, pp. 98-102. https://doi.org/10.1016/j.jad.2017.06.060
Chin-Hung Chen, Vincent ; Yang, Yao Hsu ; Chen, Pin Yuan ; Yang, Jen Tsung ; Chen, Carl P.C. ; Chen, Chi Jen ; Lu, Mong Liang ; Lee, Yena ; McIntyre, Roger S. ; Huang, Yin Cheng. / Factors affecting lumbar surgery outcome : A nation-wide, population-based retrospective study. In: Journal of Affective Disorders. 2017 ; Vol. 222. pp. 98-102.
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abstract = "Background Lower back pain is a very common symptom and treatment strategies vary according the severity and duration of illness. Surgical approaches are becoming increasingly popular with the advent of new and less invasive technologies; however, treatment outcomes are not yet well established on a population-based level. Taiwan's National Health Insurance Research Database (NHIRD) is longitudinal and includes 98{\%} of the population since its inception in 1995. The database includes the ICD 9.0 codes (International Classification of Diseases) of all patients with lower back pain and lumbar surgery; furthermore, all the prescriptions. Methods As part of a population-based cohort study of one million participants randomly selected from the NHIRD, we analyzed changes in prescription of analgesics 1 year before and 1 year after lumbar surgery; comorbidities, such as diabetes, asthma, osteoporosis, arthritis, depression and anxiety were also analyzed as covariates. A total of 3916 cases were enrolled in final analysis. Results Post-operatively, the defined daily dosage (DDD) of analgesics decreased from a median DDD of 50.0 to a median of 14.2. In a multivariate model analysis, female, older age, anxiety and asthma were the significant factors for unfavorable outcome (defined by dosage of analgesics decreased less than 50{\%} after surgery). Conclusions The analgesics significantly decreased for patients received lumbar surgeries, implying the decreased of pain. In addition, co-morbidity factors were identified by the failure for analgesics reduction, such as female, older age, anxiety and asthma. For patients with lower back pain, these factors should be considered before receiving lumbar surgeries.",
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N2 - Background Lower back pain is a very common symptom and treatment strategies vary according the severity and duration of illness. Surgical approaches are becoming increasingly popular with the advent of new and less invasive technologies; however, treatment outcomes are not yet well established on a population-based level. Taiwan's National Health Insurance Research Database (NHIRD) is longitudinal and includes 98% of the population since its inception in 1995. The database includes the ICD 9.0 codes (International Classification of Diseases) of all patients with lower back pain and lumbar surgery; furthermore, all the prescriptions. Methods As part of a population-based cohort study of one million participants randomly selected from the NHIRD, we analyzed changes in prescription of analgesics 1 year before and 1 year after lumbar surgery; comorbidities, such as diabetes, asthma, osteoporosis, arthritis, depression and anxiety were also analyzed as covariates. A total of 3916 cases were enrolled in final analysis. Results Post-operatively, the defined daily dosage (DDD) of analgesics decreased from a median DDD of 50.0 to a median of 14.2. In a multivariate model analysis, female, older age, anxiety and asthma were the significant factors for unfavorable outcome (defined by dosage of analgesics decreased less than 50% after surgery). Conclusions The analgesics significantly decreased for patients received lumbar surgeries, implying the decreased of pain. In addition, co-morbidity factors were identified by the failure for analgesics reduction, such as female, older age, anxiety and asthma. For patients with lower back pain, these factors should be considered before receiving lumbar surgeries.

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