0562 Associations of Insomnia Symptoms and Unhealthy Alcohol Use with Post-Operative Healthcare Utilization in Veterans Undergoing Decompressive Laminectomy for Lumbar Spinal Stenosis

Abstract Introduction Lumbar spinal stenosis (LSS) affects 11-39% of adults and contributes to significant pain disability. Decompressive laminectomy (DL) is a common surgical intervention for LSS but many with medical psychosocial comorbidities may not improve. Insomnia unhealthy alcohol use, example, are among people living chronic affect key outcomes, such as healthcare utilization rates. We examined associations self-reported rates post-DL in Veterans insomnia symptoms use. Methods analyzed data from multi-site prospective cohort study undergoing DL. Participants (N=200) prior 12-month use behavior (Short Michigan Alcohol Screening Test; SMAST) two-week (Insomnia Severity Index; ISI) surgery; 12-months post DL office visits, ER hospitalizations, mental health visits were reported over the telephone monthly. Negative binomial regression models via incident rate ratios (IRR) compared between individuals reporting alcohol-related problems only (SMAST >2), (ISI ≥ 8), both those neither. Results Approximately 52% participants symptoms, 75% 39% both. Rates office, ER, hospital descriptively highest only; Those had more (IRR=2.39, p=.04) (IRR=4.32, p=.03) than neither nor use; also (IRR=4.22, p=.01). Adjusting covariates rendered IRRs attenuated statistically nonsignificant, magnitudes remained high. Conclusion Most and/or utilization, including higher visits. contribute post-operative lending support assessment sleep-related pre-laminectomy. Support (If Any) This material based on work supported by Department Affairs, Health Administration, Office Research Development, grant # RX000798. Dr. Tighe Career Development/Capacity Building Award Number IK2 RX003393 United States (U.S.) Affairs Rehabilitation R&D (Rehab RD) Service. Bachrach U.S. Services Development Service (HSR&D) (CDA 20-057).