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Surgical Outcome Predictor in Degenerative Lumbar Spinal Disease Based on Health Related Quality of Life Using Euro-Quality 5 Dimensions Analysis

Authors
 Byung Ho Lee  ;  Jae-Ho Yang  ;  Hwan-Mo Lee  ;  Jun-Young Park  ;  Sang-Eun Park  ;  Seong-Hwan Moon 
Citation
 YONSEI MEDICAL JOURNAL, Vol.57(5) : 1214-1221, 2016 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2016
MeSH
Aged ; Aged, 80 and over ; Decompression, Surgical/adverse effects ; Female ; Health* ; Humans ; Lumbar Vertebrae/surgery* ; Male ; Middle Aged ; Postoperative Complications/etiology ; Postoperative Complications/psychology ; Postoperative Period ; Prognosis ; Prospective Studies ; Quality of Life* ; Self Care ; Spinal Diseases/diagnosis ; Spinal Diseases/surgery* ; Surveys and Questionnaires ; Treatment Outcome
Keywords
Lumbar vertebrae ; degenerative ; outcome assessment ; spinal disease ; surgical procedure
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.
Files in This Item:
T201602863.pdf Download
DOI
10.3349/ymj.2016.57.5.1214
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Moon, Seong Hwan(문성환)
Park, Jun Young(박준영) ORCID logo https://orcid.org/0000-0002-4713-4036
Yang, Jae Ho(양재호) ORCID logo https://orcid.org/0000-0001-7421-2805
Lee, Hwan Mo(이환모) ORCID logo https://orcid.org/0000-0002-5405-3832
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151796
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