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Mental Health Associated With Postoperative Satisfaction in Lumbar Degenerative Surgery Patients.

Abstract：

STUDY DESIGN:Retrospective review of prospectively collected data OBJECTIVE:: To assess the association between preoperative and postoperative mental health status with postoperative satisfaction in lumbar degenerative surgery patients. SUMMARY OF BACKGROUND DATA:Poor preoperative mental health has been shown to negatively affect postoperative satisfaction among spine surgery patients, but there is limited evidence on the impact of postoperative mental health on satisfaction. MATERIALS AND METHODS:Adult patients undergoing surgery for lumbar degenerative conditions at a single institution were included. Mental health was assessed preoperatively and 12 months postoperatively using Patient-Reported Outcomes Measurement Information System Depression and Anxiety scores. Satisfaction was assessed 12 months postoperatively using North American Spine Society Patient Satisfaction Index. The authors evaluated associations between mental health and satisfaction with univariate and multivariable logistic regression to adjust for confounders. Preoperative depression/anxiety level was corrected for postoperative depression/anxiety level, and vice versa. Statistical significance was assessed at α=0.05. RESULTS:A total of 183 patients (47% male individuals; avg. age, 62 y) were included. Depression was present in 27% preoperatively and 29% postoperatively, and anxiety in 50% preoperatively and 31% postoperatively. Ninteen percent reported postoperative dissatisfaction using the North American Spine Society Patient Satisfaction Index. Univariate analysis identified race, family income, relationship status, current smoking status, change in pain interference, and change in physical function as potential confounders. In adjusted analysis, odds of dissatisfaction were increased in those with mild postoperative depression (adjusted odds ratio=6.1; 95% confidence interval, 1.2-32; P=0.03) and moderate or severe postoperative depression (adjusted odds ratio=7.5; 95% confidence interval, 1.3-52; P=0.03). Preoperative and postoperative anxiety and preoperative depression were not associated with postoperative satisfaction. CONCLUSIONS:Following lumbar degenerative surgery, patients with postoperative depression, irrespective of preoperative depression status, have significantly higher odds of dissatisfaction. These results emphasize the importance of postoperative screening and treatment of depression in spine patients with dissatisfaction. LEVEL OF EVIDENCE:Level III-nonrandomized cohort study.

journal_name

Clin Spine Surg

journal_title

Clinical spine surgery

authors

Rahman R,Zhang B,Andrade NS,Ibaseta A,Kebaish KM,Riley LH 3rd,Cohen DB,Jain A,Lee SH,Sciubba DM,Skolasky RL,Neuman BJ

doi

10.1097/BSD.0000000000001106

subject

Has Abstract

pub_date

2020-12-08 00:00:00

eissn

2380-0186

issn

2380-0194

pub_type

杂志文章

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Mental Health Associated With Postoperative Satisfaction in Lumbar Degenerative Surgery Patients.