Women fare best following surgery for degenerative lumbar spondylolisthesis: A comparison of the most and least satisfied patients utilizing data from the Quality Outcomes Database

Andrew K. Chan, Erica F. Bisson, Mohamad Bydon, Steven D. Glassman, Kevin Foley, Eric A. Potts, Christopher I. Shaffrey, Mark E. Shaffrey, Domagoj Coric, John J. Knightly, Paul Park, Kai Ming Fu, Jonathan R. Slotkin, Anthony L. Asher, Michael S. Virk, Panagiotis Kerezoudis, Silky Chotai, Anthony M. DiGiorgio, Alvin Y. Chan, Regis W. HaidPraveen V. Mummaneni

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVE The American Association of Neurological Surgeons launched the Quality Outcomes Database (QOD), a prospective longitudinal registry that includes demographic, clinical, and patient-reported outcome (PRO) data, to measure the safety and quality of neurosurgical procedures, including spinal surgery. Differing results from recent randomized controlled trials have established a need to clarify the groups that would most benefit from surgery for degenerative lumbar spondylolisthesis. In the present study, the authors compared patients who were the most and the least satisfied following surgery for degenerative lumbar spondylolisthesis. METHODS This was a retrospective analysis of a prospective, national longitudinal registry including patients who had undergone surgery for grade 1 degenerative lumbar spondylolisthesis. The most and least satisfied patients were identified based on an answer of "1" and "4," respectively, on the North American Spine Society (NASS) Satisfaction Questionnaire 12 months postoperatively. Baseline demographics, clinical variables, surgical parameters, and outcomes were collected. Patient-reported outcome measures, including the Numeric Rating Scale (NRS) for back pain, NRS for leg pain, Oswestry Disability Index (ODI), and EQ-5D (the EuroQol health survey), were administered at baseline and 3 and 12 months after treatment. RESULTS Four hundred seventy-seven patients underwent surgery for grade 1 degenerative lumbar spondylolisthesis in the period from July 2014 through December 2015. Two hundred fifty-five patients (53.5%) were the most satisfied and 26 (5.5%) were the least satisfied. Compared with the most satisfied patients, the least satisfied ones more often had coronary artery disease (CAD; 26.9% vs 12.2%, p = 0.04) and had higher body mass indices (32.9 ± 6.5 vs 30.0 ± 6.0 kg/m2, p = 0.02). In the multivariate analysis, female sex (OR 2.9, p = 0.02) was associated with the most satisfaction. Notably, the American Society of Anesthesiologists (ASA) class, smoking, psychiatric comorbidity, and employment status were not significantly associated with satisfaction. Although there were no significant differences at baseline, the most satisfied patients had significantly lower NRS back and leg pain and ODI scores and a greater EQ-5D score at 3 and 12 months postoperatively (p < 0.001 for all). CONCLUSIONS This study revealed that some patient factors differ between those who report the most and those who report the least satisfaction after surgery for degenerative lumbar spondylolisthesis. Patients reporting the least satisfaction tended to have CAD or were obese. Female sex was associated with the most satisfaction when adjusting for potential covariates. These findings highlight several key factors that could aid in setting expectations for outcomes following surgery for degenerative lumbar spondylolisthesis.

Original languageEnglish (US)
Article numberE3
JournalNeurosurgical focus
Volume44
Issue number1
DOIs
StatePublished - Jan 1 2018

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Spondylolisthesis
Databases
Back Pain
Registries
Leg
Demography
Neurosurgical Procedures
Data Accuracy
Health Surveys
Psychiatry
Comorbidity
Coronary Artery Disease
Body Mass Index
Multivariate Analysis
Randomized Controlled Trials
Smoking
Safety
Pain

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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Women fare best following surgery for degenerative lumbar spondylolisthesis : A comparison of the most and least satisfied patients utilizing data from the Quality Outcomes Database. / Chan, Andrew K.; Bisson, Erica F.; Bydon, Mohamad; Glassman, Steven D.; Foley, Kevin; Potts, Eric A.; Shaffrey, Christopher I.; Shaffrey, Mark E.; Coric, Domagoj; Knightly, John J.; Park, Paul; Fu, Kai Ming; Slotkin, Jonathan R.; Asher, Anthony L.; Virk, Michael S.; Kerezoudis, Panagiotis; Chotai, Silky; DiGiorgio, Anthony M.; Chan, Alvin Y.; Haid, Regis W.; Mummaneni, Praveen V.

In: Neurosurgical focus, Vol. 44, No. 1, E3, 01.01.2018.

Research output: Contribution to journalArticle

Chan, AK, Bisson, EF, Bydon, M, Glassman, SD, Foley, K, Potts, EA, Shaffrey, CI, Shaffrey, ME, Coric, D, Knightly, JJ, Park, P, Fu, KM, Slotkin, JR, Asher, AL, Virk, MS, Kerezoudis, P, Chotai, S, DiGiorgio, AM, Chan, AY, Haid, RW & Mummaneni, PV 2018, 'Women fare best following surgery for degenerative lumbar spondylolisthesis: A comparison of the most and least satisfied patients utilizing data from the Quality Outcomes Database', Neurosurgical focus, vol. 44, no. 1, E3. https://doi.org/10.3171/2017.10.FOCUS17553
Chan, Andrew K. ; Bisson, Erica F. ; Bydon, Mohamad ; Glassman, Steven D. ; Foley, Kevin ; Potts, Eric A. ; Shaffrey, Christopher I. ; Shaffrey, Mark E. ; Coric, Domagoj ; Knightly, John J. ; Park, Paul ; Fu, Kai Ming ; Slotkin, Jonathan R. ; Asher, Anthony L. ; Virk, Michael S. ; Kerezoudis, Panagiotis ; Chotai, Silky ; DiGiorgio, Anthony M. ; Chan, Alvin Y. ; Haid, Regis W. ; Mummaneni, Praveen V. / Women fare best following surgery for degenerative lumbar spondylolisthesis : A comparison of the most and least satisfied patients utilizing data from the Quality Outcomes Database. In: Neurosurgical focus. 2018 ; Vol. 44, No. 1.
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abstract = "OBJECTIVE The American Association of Neurological Surgeons launched the Quality Outcomes Database (QOD), a prospective longitudinal registry that includes demographic, clinical, and patient-reported outcome (PRO) data, to measure the safety and quality of neurosurgical procedures, including spinal surgery. Differing results from recent randomized controlled trials have established a need to clarify the groups that would most benefit from surgery for degenerative lumbar spondylolisthesis. In the present study, the authors compared patients who were the most and the least satisfied following surgery for degenerative lumbar spondylolisthesis. METHODS This was a retrospective analysis of a prospective, national longitudinal registry including patients who had undergone surgery for grade 1 degenerative lumbar spondylolisthesis. The most and least satisfied patients were identified based on an answer of {"}1{"} and {"}4,{"} respectively, on the North American Spine Society (NASS) Satisfaction Questionnaire 12 months postoperatively. Baseline demographics, clinical variables, surgical parameters, and outcomes were collected. Patient-reported outcome measures, including the Numeric Rating Scale (NRS) for back pain, NRS for leg pain, Oswestry Disability Index (ODI), and EQ-5D (the EuroQol health survey), were administered at baseline and 3 and 12 months after treatment. RESULTS Four hundred seventy-seven patients underwent surgery for grade 1 degenerative lumbar spondylolisthesis in the period from July 2014 through December 2015. Two hundred fifty-five patients (53.5{\%}) were the most satisfied and 26 (5.5{\%}) were the least satisfied. Compared with the most satisfied patients, the least satisfied ones more often had coronary artery disease (CAD; 26.9{\%} vs 12.2{\%}, p = 0.04) and had higher body mass indices (32.9 ± 6.5 vs 30.0 ± 6.0 kg/m2, p = 0.02). In the multivariate analysis, female sex (OR 2.9, p = 0.02) was associated with the most satisfaction. Notably, the American Society of Anesthesiologists (ASA) class, smoking, psychiatric comorbidity, and employment status were not significantly associated with satisfaction. Although there were no significant differences at baseline, the most satisfied patients had significantly lower NRS back and leg pain and ODI scores and a greater EQ-5D score at 3 and 12 months postoperatively (p < 0.001 for all). CONCLUSIONS This study revealed that some patient factors differ between those who report the most and those who report the least satisfaction after surgery for degenerative lumbar spondylolisthesis. Patients reporting the least satisfaction tended to have CAD or were obese. Female sex was associated with the most satisfaction when adjusting for potential covariates. These findings highlight several key factors that could aid in setting expectations for outcomes following surgery for degenerative lumbar spondylolisthesis.",
author = "Chan, {Andrew K.} and Bisson, {Erica F.} and Mohamad Bydon and Glassman, {Steven D.} and Kevin Foley and Potts, {Eric A.} and Shaffrey, {Christopher I.} and Shaffrey, {Mark E.} and Domagoj Coric and Knightly, {John J.} and Paul Park and Fu, {Kai Ming} and Slotkin, {Jonathan R.} and Asher, {Anthony L.} and Virk, {Michael S.} and Panagiotis Kerezoudis and Silky Chotai and DiGiorgio, {Anthony M.} and Chan, {Alvin Y.} and Haid, {Regis W.} and Mummaneni, {Praveen V.}",
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TY - JOUR

T1 - Women fare best following surgery for degenerative lumbar spondylolisthesis

T2 - A comparison of the most and least satisfied patients utilizing data from the Quality Outcomes Database

AU - Chan, Andrew K.

AU - Bisson, Erica F.

AU - Bydon, Mohamad

AU - Glassman, Steven D.

AU - Foley, Kevin

AU - Potts, Eric A.

AU - Shaffrey, Christopher I.

AU - Shaffrey, Mark E.

AU - Coric, Domagoj

AU - Knightly, John J.

AU - Park, Paul

AU - Fu, Kai Ming

AU - Slotkin, Jonathan R.

AU - Asher, Anthony L.

AU - Virk, Michael S.

AU - Kerezoudis, Panagiotis

AU - Chotai, Silky

AU - DiGiorgio, Anthony M.

AU - Chan, Alvin Y.

AU - Haid, Regis W.

AU - Mummaneni, Praveen V.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - OBJECTIVE The American Association of Neurological Surgeons launched the Quality Outcomes Database (QOD), a prospective longitudinal registry that includes demographic, clinical, and patient-reported outcome (PRO) data, to measure the safety and quality of neurosurgical procedures, including spinal surgery. Differing results from recent randomized controlled trials have established a need to clarify the groups that would most benefit from surgery for degenerative lumbar spondylolisthesis. In the present study, the authors compared patients who were the most and the least satisfied following surgery for degenerative lumbar spondylolisthesis. METHODS This was a retrospective analysis of a prospective, national longitudinal registry including patients who had undergone surgery for grade 1 degenerative lumbar spondylolisthesis. The most and least satisfied patients were identified based on an answer of "1" and "4," respectively, on the North American Spine Society (NASS) Satisfaction Questionnaire 12 months postoperatively. Baseline demographics, clinical variables, surgical parameters, and outcomes were collected. Patient-reported outcome measures, including the Numeric Rating Scale (NRS) for back pain, NRS for leg pain, Oswestry Disability Index (ODI), and EQ-5D (the EuroQol health survey), were administered at baseline and 3 and 12 months after treatment. RESULTS Four hundred seventy-seven patients underwent surgery for grade 1 degenerative lumbar spondylolisthesis in the period from July 2014 through December 2015. Two hundred fifty-five patients (53.5%) were the most satisfied and 26 (5.5%) were the least satisfied. Compared with the most satisfied patients, the least satisfied ones more often had coronary artery disease (CAD; 26.9% vs 12.2%, p = 0.04) and had higher body mass indices (32.9 ± 6.5 vs 30.0 ± 6.0 kg/m2, p = 0.02). In the multivariate analysis, female sex (OR 2.9, p = 0.02) was associated with the most satisfaction. Notably, the American Society of Anesthesiologists (ASA) class, smoking, psychiatric comorbidity, and employment status were not significantly associated with satisfaction. Although there were no significant differences at baseline, the most satisfied patients had significantly lower NRS back and leg pain and ODI scores and a greater EQ-5D score at 3 and 12 months postoperatively (p < 0.001 for all). CONCLUSIONS This study revealed that some patient factors differ between those who report the most and those who report the least satisfaction after surgery for degenerative lumbar spondylolisthesis. Patients reporting the least satisfaction tended to have CAD or were obese. Female sex was associated with the most satisfaction when adjusting for potential covariates. These findings highlight several key factors that could aid in setting expectations for outcomes following surgery for degenerative lumbar spondylolisthesis.

AB - OBJECTIVE The American Association of Neurological Surgeons launched the Quality Outcomes Database (QOD), a prospective longitudinal registry that includes demographic, clinical, and patient-reported outcome (PRO) data, to measure the safety and quality of neurosurgical procedures, including spinal surgery. Differing results from recent randomized controlled trials have established a need to clarify the groups that would most benefit from surgery for degenerative lumbar spondylolisthesis. In the present study, the authors compared patients who were the most and the least satisfied following surgery for degenerative lumbar spondylolisthesis. METHODS This was a retrospective analysis of a prospective, national longitudinal registry including patients who had undergone surgery for grade 1 degenerative lumbar spondylolisthesis. The most and least satisfied patients were identified based on an answer of "1" and "4," respectively, on the North American Spine Society (NASS) Satisfaction Questionnaire 12 months postoperatively. Baseline demographics, clinical variables, surgical parameters, and outcomes were collected. Patient-reported outcome measures, including the Numeric Rating Scale (NRS) for back pain, NRS for leg pain, Oswestry Disability Index (ODI), and EQ-5D (the EuroQol health survey), were administered at baseline and 3 and 12 months after treatment. RESULTS Four hundred seventy-seven patients underwent surgery for grade 1 degenerative lumbar spondylolisthesis in the period from July 2014 through December 2015. Two hundred fifty-five patients (53.5%) were the most satisfied and 26 (5.5%) were the least satisfied. Compared with the most satisfied patients, the least satisfied ones more often had coronary artery disease (CAD; 26.9% vs 12.2%, p = 0.04) and had higher body mass indices (32.9 ± 6.5 vs 30.0 ± 6.0 kg/m2, p = 0.02). In the multivariate analysis, female sex (OR 2.9, p = 0.02) was associated with the most satisfaction. Notably, the American Society of Anesthesiologists (ASA) class, smoking, psychiatric comorbidity, and employment status were not significantly associated with satisfaction. Although there were no significant differences at baseline, the most satisfied patients had significantly lower NRS back and leg pain and ODI scores and a greater EQ-5D score at 3 and 12 months postoperatively (p < 0.001 for all). CONCLUSIONS This study revealed that some patient factors differ between those who report the most and those who report the least satisfaction after surgery for degenerative lumbar spondylolisthesis. Patients reporting the least satisfaction tended to have CAD or were obese. Female sex was associated with the most satisfaction when adjusting for potential covariates. These findings highlight several key factors that could aid in setting expectations for outcomes following surgery for degenerative lumbar spondylolisthesis.

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