TY - JOUR
T1 - Can early patient-reported outcomes be used to identify patients at risk for poor 1-year health outcomes after lumbar laminectomy with arthrodesis?
AU - Purvis, Taylor E.
AU - Neuman, Brian J.
AU - Riley, Lee H.
AU - Skolasky, Richard L.
N1 - Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Study Design. Prospective cohort. Objective. Determine A) between-patient variability in patient-reported outcomes (PROs) at four postoperative time points; B) within-patient correlation of 1-year PROs with PROs at three earlier time points; and C) ability of early PROs to predict 1-year PROs after lumbar laminectomy with arthrodesis. Summary of Background Data. It is unclear whether early PROs can help identify patients at risk for poor health outcomes. Methods. Between 2015 and 2016, we assessed pre- A nd postoperative back pain, leg pain, disability, physical health, and mental health in 146 patients. We examined PRO variability between patients and correlations within patients during the first postoperative year. For early (≤3-mo) and 1-year PROs, we examined concordance between experiencing a minimal important difference (MID) early and at 1 year and odds of experiencing a 1-year MID given early absence of a MID. Results. Postoperatively, we found increasing between-patient variability of PROs. For individual patients, we found moderate to strong between-assessment correlations (intraclass correlations) between repeated PROs (back pain, 0.47; leg pain, 0.51; disability, 0.47; physical health, 0.63; mental health, 0.53). Early MIDs were experienced for back pain (57%), leg pain (52%), physical health (38%), disability (34%), and mental health (16%). Concordance was moderate for leg pain (0.48), mental health (0.46), disability (0.38), back pain (0.36), and physical health (0.25). In patients without an early MID, odds of experiencing a MID at 1 year were low for physical health (odds ratio [OR] = 0.33), back pain (OR = 0.30), leg pain (OR = 0.14), and disability (OR = 0.11) but not mental health (OR = 0.50). Conclusion. Although postoperative recovery is variable, early PROs can identify patients at risk for poor 1-year outcomes and may help tailor care during the first year after lumbar laminectomy with arthrodesis.
AB - Study Design. Prospective cohort. Objective. Determine A) between-patient variability in patient-reported outcomes (PROs) at four postoperative time points; B) within-patient correlation of 1-year PROs with PROs at three earlier time points; and C) ability of early PROs to predict 1-year PROs after lumbar laminectomy with arthrodesis. Summary of Background Data. It is unclear whether early PROs can help identify patients at risk for poor health outcomes. Methods. Between 2015 and 2016, we assessed pre- A nd postoperative back pain, leg pain, disability, physical health, and mental health in 146 patients. We examined PRO variability between patients and correlations within patients during the first postoperative year. For early (≤3-mo) and 1-year PROs, we examined concordance between experiencing a minimal important difference (MID) early and at 1 year and odds of experiencing a 1-year MID given early absence of a MID. Results. Postoperatively, we found increasing between-patient variability of PROs. For individual patients, we found moderate to strong between-assessment correlations (intraclass correlations) between repeated PROs (back pain, 0.47; leg pain, 0.51; disability, 0.47; physical health, 0.63; mental health, 0.53). Early MIDs were experienced for back pain (57%), leg pain (52%), physical health (38%), disability (34%), and mental health (16%). Concordance was moderate for leg pain (0.48), mental health (0.46), disability (0.38), back pain (0.36), and physical health (0.25). In patients without an early MID, odds of experiencing a MID at 1 year were low for physical health (odds ratio [OR] = 0.33), back pain (OR = 0.30), leg pain (OR = 0.14), and disability (OR = 0.11) but not mental health (OR = 0.50). Conclusion. Although postoperative recovery is variable, early PROs can identify patients at risk for poor 1-year outcomes and may help tailor care during the first year after lumbar laminectomy with arthrodesis.
KW - Oswestry Disability Index
KW - Short-Form 12-Item Health Survey
KW - arthrodesis
KW - brief pain inventory
KW - disability
KW - lumbar laminectomy
KW - lumbar spine
KW - pain
KW - patient counseling
KW - patient-reported outcomes
KW - version 2
UR - http://www.scopus.com/inward/record.url?scp=85050077532&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85050077532&partnerID=8YFLogxK
U2 - 10.1097/BRS.0000000000002522
DO - 10.1097/BRS.0000000000002522
M3 - Article
C2 - 29215506
AN - SCOPUS:85050077532
SN - 0362-2436
VL - 43
SP - 1067
EP - 1073
JO - Spine
JF - Spine
IS - 15
ER -