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

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. CONCLUSION: Spinal surgery and opioid utilization are associated with catastrophic claim costs.