Effect of patients’ functional status on satisfaction with outcomes 12 months after elective spine surgery for lumbar degenerative disease

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Abstract

Background Comprehensive assessment of quality of care includes patient-reported outcomes, safety of care delivered, and patient satisfaction. The impact of the patient-reported Oswestry Disability Index (ODI) scores at baseline and 12 months on satisfaction with outcomes following spine surgery is not well documented. Purpose This study aimed to determine the impact of patient disability (ODI) scores at baseline and 12 months on satisfaction with outcomes following surgery. Study Design Analysis of prospectively collected longitudinal web-based multicenter data. Patient Sample Patients undergoing elective surgery for degenerative lumbar disease were entered into a prospective multicenter registry. Outcome Measures Primary outcome measures were ODI, North American Spine Society satisfaction (NASS) questionnaire. Methods Baseline and 12-month ODI scores were recorded. Satisfaction at 12 months after surgery was measured using NASS questionnaire. Multivariable proportional odds logistic regression analysis was conducted to determine the impact of baseline and 12-month ODI on satisfaction with outcomes. Results Of the total 5,443 patients, 64% (n=3,460) were satisfied at a level where surgery met their expectations (NASS level 1) at 12 months after surgery. After adjusting for all baseline and surgery-specific variables, the 12-month ODI score had the highest impact (Wald χ2=1,555, 86% of the total χ2) on achieving satisfaction with outcomes compared with baseline ODI scores (Wald χ2=93, 5% of the total χ2). The level of satisfaction decreases with increasing 12-month ODI score. Greater change in ODI is required to achieve a better satisfaction level when the patient starts with a higher baseline ODI score. Conclusion Absolute 12-month ODI following surgery had a significant association on satisfaction with outcomes 12 months after surgery. Patients with higher baseline ODI required a larger change in ODI score to achieve satisfaction. No single measure can be used as a sole yardstick to measure quality of care after spine surgery. Satisfaction may be used in conjunction with baseline and 12-month ODI scores to provide an assessment of the quality of spine surgery provided in a patient centric fashion.

Original languageEnglish (US)
Pages (from-to)1783-1793
Number of pages11
JournalSpine Journal
Volume17
Issue number12
DOIs
StatePublished - Dec 1 2017

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Spine
Quality of Health Care
Outcome Assessment (Health Care)
Patient Satisfaction
Registries
Logistic Models
Regression Analysis
Safety

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Effect of patients’ functional status on satisfaction with outcomes 12 months after elective spine surgery for lumbar degenerative disease. / for.

In: Spine Journal, Vol. 17, No. 12, 01.12.2017, p. 1783-1793.

Research output: Contribution to journalArticle

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title = "Effect of patients’ functional status on satisfaction with outcomes 12 months after elective spine surgery for lumbar degenerative disease",
abstract = "Background Comprehensive assessment of quality of care includes patient-reported outcomes, safety of care delivered, and patient satisfaction. The impact of the patient-reported Oswestry Disability Index (ODI) scores at baseline and 12 months on satisfaction with outcomes following spine surgery is not well documented. Purpose This study aimed to determine the impact of patient disability (ODI) scores at baseline and 12 months on satisfaction with outcomes following surgery. Study Design Analysis of prospectively collected longitudinal web-based multicenter data. Patient Sample Patients undergoing elective surgery for degenerative lumbar disease were entered into a prospective multicenter registry. Outcome Measures Primary outcome measures were ODI, North American Spine Society satisfaction (NASS) questionnaire. Methods Baseline and 12-month ODI scores were recorded. Satisfaction at 12 months after surgery was measured using NASS questionnaire. Multivariable proportional odds logistic regression analysis was conducted to determine the impact of baseline and 12-month ODI on satisfaction with outcomes. Results Of the total 5,443 patients, 64{\%} (n=3,460) were satisfied at a level where surgery met their expectations (NASS level 1) at 12 months after surgery. After adjusting for all baseline and surgery-specific variables, the 12-month ODI score had the highest impact (Wald χ2=1,555, 86{\%} of the total χ2) on achieving satisfaction with outcomes compared with baseline ODI scores (Wald χ2=93, 5{\%} of the total χ2). The level of satisfaction decreases with increasing 12-month ODI score. Greater change in ODI is required to achieve a better satisfaction level when the patient starts with a higher baseline ODI score. Conclusion Absolute 12-month ODI following surgery had a significant association on satisfaction with outcomes 12 months after surgery. Patients with higher baseline ODI required a larger change in ODI score to achieve satisfaction. No single measure can be used as a sole yardstick to measure quality of care after spine surgery. Satisfaction may be used in conjunction with baseline and 12-month ODI scores to provide an assessment of the quality of spine surgery provided in a patient centric fashion.",
author = "for and Silky Chotai and Devin, {Clinton J.} and Archer, {Kristin R.} and Mohamad Bydon and McGirt, {Matthew J.} and Hui Nian and Harrell, {Frank E.} and Dittus, {Robert S.} and Asher, {Anthony L.} and Asher, {Anthony L.} and McGirt, {Matthew J.} and Devin, {Clinton J.} and Foley, {Kevin T.} and Kevin Foley and Jeffrey Sorenson and Glassman, {Steven D.} and Briggs, {Thomas B.} and Adam Kremer and Griffitt, {Wesley E.} and Stadlan, {Noam Y.} and Grahm, {Thomas W.} and Schmidt, {Meic H.} and Praveen Mummaneni and Shaffrey, {Mark E.}",
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T1 - Effect of patients’ functional status on satisfaction with outcomes 12 months after elective spine surgery for lumbar degenerative disease

AU - for

AU - Chotai, Silky

AU - Devin, Clinton J.

AU - Archer, Kristin R.

AU - Bydon, Mohamad

AU - McGirt, Matthew J.

AU - Nian, Hui

AU - Harrell, Frank E.

AU - Dittus, Robert S.

AU - Asher, Anthony L.

AU - Asher, Anthony L.

AU - McGirt, Matthew J.

AU - Devin, Clinton J.

AU - Foley, Kevin T.

AU - Foley, Kevin

AU - Sorenson, Jeffrey

AU - Glassman, Steven D.

AU - Briggs, Thomas B.

AU - Kremer, Adam

AU - Griffitt, Wesley E.

AU - Stadlan, Noam Y.

AU - Grahm, Thomas W.

AU - Schmidt, Meic H.

AU - Mummaneni, Praveen

AU - Shaffrey, Mark E.

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Background Comprehensive assessment of quality of care includes patient-reported outcomes, safety of care delivered, and patient satisfaction. The impact of the patient-reported Oswestry Disability Index (ODI) scores at baseline and 12 months on satisfaction with outcomes following spine surgery is not well documented. Purpose This study aimed to determine the impact of patient disability (ODI) scores at baseline and 12 months on satisfaction with outcomes following surgery. Study Design Analysis of prospectively collected longitudinal web-based multicenter data. Patient Sample Patients undergoing elective surgery for degenerative lumbar disease were entered into a prospective multicenter registry. Outcome Measures Primary outcome measures were ODI, North American Spine Society satisfaction (NASS) questionnaire. Methods Baseline and 12-month ODI scores were recorded. Satisfaction at 12 months after surgery was measured using NASS questionnaire. Multivariable proportional odds logistic regression analysis was conducted to determine the impact of baseline and 12-month ODI on satisfaction with outcomes. Results Of the total 5,443 patients, 64% (n=3,460) were satisfied at a level where surgery met their expectations (NASS level 1) at 12 months after surgery. After adjusting for all baseline and surgery-specific variables, the 12-month ODI score had the highest impact (Wald χ2=1,555, 86% of the total χ2) on achieving satisfaction with outcomes compared with baseline ODI scores (Wald χ2=93, 5% of the total χ2). The level of satisfaction decreases with increasing 12-month ODI score. Greater change in ODI is required to achieve a better satisfaction level when the patient starts with a higher baseline ODI score. Conclusion Absolute 12-month ODI following surgery had a significant association on satisfaction with outcomes 12 months after surgery. Patients with higher baseline ODI required a larger change in ODI score to achieve satisfaction. No single measure can be used as a sole yardstick to measure quality of care after spine surgery. Satisfaction may be used in conjunction with baseline and 12-month ODI scores to provide an assessment of the quality of spine surgery provided in a patient centric fashion.

AB - Background Comprehensive assessment of quality of care includes patient-reported outcomes, safety of care delivered, and patient satisfaction. The impact of the patient-reported Oswestry Disability Index (ODI) scores at baseline and 12 months on satisfaction with outcomes following spine surgery is not well documented. Purpose This study aimed to determine the impact of patient disability (ODI) scores at baseline and 12 months on satisfaction with outcomes following surgery. Study Design Analysis of prospectively collected longitudinal web-based multicenter data. Patient Sample Patients undergoing elective surgery for degenerative lumbar disease were entered into a prospective multicenter registry. Outcome Measures Primary outcome measures were ODI, North American Spine Society satisfaction (NASS) questionnaire. Methods Baseline and 12-month ODI scores were recorded. Satisfaction at 12 months after surgery was measured using NASS questionnaire. Multivariable proportional odds logistic regression analysis was conducted to determine the impact of baseline and 12-month ODI on satisfaction with outcomes. Results Of the total 5,443 patients, 64% (n=3,460) were satisfied at a level where surgery met their expectations (NASS level 1) at 12 months after surgery. After adjusting for all baseline and surgery-specific variables, the 12-month ODI score had the highest impact (Wald χ2=1,555, 86% of the total χ2) on achieving satisfaction with outcomes compared with baseline ODI scores (Wald χ2=93, 5% of the total χ2). The level of satisfaction decreases with increasing 12-month ODI score. Greater change in ODI is required to achieve a better satisfaction level when the patient starts with a higher baseline ODI score. Conclusion Absolute 12-month ODI following surgery had a significant association on satisfaction with outcomes 12 months after surgery. Patients with higher baseline ODI required a larger change in ODI score to achieve satisfaction. No single measure can be used as a sole yardstick to measure quality of care after spine surgery. Satisfaction may be used in conjunction with baseline and 12-month ODI scores to provide an assessment of the quality of spine surgery provided in a patient centric fashion.

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DO - 10.1016/j.spinee.2017.05.027

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EP - 1793

JO - Spine Journal

JF - Spine Journal

SN - 1529-9430

IS - 12

ER -