Surgical Outcome Predictor in Degenerative Lumbar Spinal Disease Based on Health Related Quality of Life Using Euro-Quality 5 Dimensions Analysis.
10.3349/ymj.2016.57.5.1214
- Author:
Byung Ho LEE
1
;
Jae Ho YANG
;
Hwan Mo LEE
;
Jun Young PARK
;
Sang Eun PARK
;
Seong Hwan MOON
Author Information
1. Department of Orthopedic Surgery, Catholic Kwandong University College of Medicine, Incheon, Korea.
- Publication Type:Clinical Trial ; Original Article ; Multicenter Study
- Keywords:
Lumbar vertebrae;
outcome assessment;
surgical procedure;
degenerative;
spinal disease
- MeSH:
Aged;
Aged, 80 and over;
Decompression, Surgical/adverse effects;
Female;
*Health;
Humans;
Lumbar Vertebrae/*surgery;
Male;
Middle Aged;
Postoperative Complications/etiology/psychology;
Postoperative Period;
Prognosis;
Prospective Studies;
*Quality of Life;
Self Care;
Spinal Diseases/diagnosis/*surgery;
Surveys and Questionnaires;
Treatment Outcome
- From:Yonsei Medical Journal
2016;57(5):1214-1221
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We aim to introduce the predictive value of a quantitatively described formula model in a multicenter prospective analysis using the EuroQol-5 dimensions (EQ-5D) health scale to anticipate postoperative improvement in patients with degenerative lumbar spine disease (DLSD). MATERIALS AND METHODS: Quality of life was evaluated in 376 patients from 17 tertiary hospitals before and after spinal decompression and fusion surgery. The five items of the EQ-5D, mobility (M), self-care (S), usual activities (A), pain/discomfort (P), and anxiety/depression (D), were checked as level 1, 2, or 3, with 3 being the worst. A minimal significant change in the calculated EQ-5D (cEQ-5D) was set as 0.05. Logistic regression analysis was performed to predict the highest successful outcome (cEQ-5D improvement after operation >0.05) with the given sets of 5 items of the EQ-5D. RESULTS: In the cEQ-5D analysis, among patients with a formula score of S+A+2×P+D≤8, 18/68 (27%) showed significant improvement in the cEQ-5D at 1 year postoperatively (p<0.05). However, in patients with a formula score of ≥9, 265/308 (86%) demonstrated significant improvements in the cEQ-5D at 1 year postoperatively (p<0.05). CONCLUSION: We suggest that S+A+2×P+D≥9 in the EQ-5D can quantitatively describe the better surgical outcome predictors for DLSD. With a definite DLSD lesion confirmed by an imaging study, patients who meet the formula scores of 9 or over and have refractory symptoms to non-operative treatment could be better surgical candidates resulting in satisfactory surgical outcomes of over 86%, than those who scored 8 or lower.
