Patient Satisfaction Following Lumbar Fusion Is Associated With Functional Status and Pain More Than the Attainment of Minimal Clinically Important Difference: Implications for Value-Based Medicine.
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引用次数: 0
Abstract
Background: In an era of value-based medicine, patient-perceived benefit and satisfaction are of paramount importance. However, current metrics of success such as the minimal clinically important difference (MCID) do not always correlate with overall patient satisfaction. Therefore, the purpose of this study was to understand the relationships between self-reported pain, Oswestry Disability Index (ODI) scores, reaching the MCID, and overall patient satisfaction in patients undergoing elective lumbar fusions.
Methods: A retrospective study including patients between the ages of 18 and 89 years old who underwent a 1- or 2-level elective lumbar fusion between June 2021 and June 2023. Patients were stratified using this overall level of satisfaction with their procedure. Differences in clinical metrics and patient-reported outcome scores among satisfaction levels were assessed, and predictive analytics were used to determine whether clinical metrics were associated with satisfaction.
Results: A total of 343 patients were included in this study; 81% indicated they were satisfied with their overall outcomes. There were differences in both clinical metrics and patient-reported outcomes based on satisfaction level. Current pain and function were found to be independent predictors of satisfaction, while ODI scores and reaching MCID were not.
Clinical relevance: Relying on meeting statistically defined benchmarks of success, such as the MCID, may not provide an accurate depiction of procedural success or patient satisfaction, and additional clinically relevant benchmarks should also be assessed.
Conclusions: Pain and current function were significantly associated with patient satisfaction; therefore, these metrics may play a larger role in patient satisfaction and perceived benefit than assessment through the ODI alone.
期刊介绍：
The International Journal of Spine Surgery is the official scientific journal of ISASS, the International Intradiscal Therapy Society, the Pittsburgh Spine Summit, and the Büttner-Janz Spinefoundation, and is an official partner of the Southern Neurosurgical Society. The goal of the International Journal of Spine Surgery is to promote and disseminate online the most up-to-date scientific and clinical research into innovations in motion preservation and new spinal surgery technology, including basic science, biologics, and tissue engineering. The Journal is dedicated to educating spine surgeons worldwide by reporting on the scientific basis, indications, surgical techniques, complications, outcomes, and follow-up data for promising spinal procedures.
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