Judith van Grafhorst, Wouter van Furth, Carmen Vleggeert-Lankamp
{"title":"心理状态是脊柱狭窄症手术疗效的预测因素:整合患者满意度和功能结果的四象限模型。","authors":"Judith van Grafhorst, Wouter van Furth, Carmen Vleggeert-Lankamp","doi":"10.1016/j.bas.2024.103902","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Mental status, characterised by anxiety and depression, significantly influences physical well-being, particularly in patients with spinal stenosis symptoms.</p><p><strong>Research question: </strong>The prevalence of depression and anxiety in our cohort. The correlation between psychological distress and physical outcome after surgery, including postoperative recovery and satisfaction.</p><p><strong>Materials and methods: </strong>Questionnaires evaluating anxiety and depression (HADS), functionality (ODI), quality of life (EQ-5D), and perceived recovery (Likert-scale) were sent to a randomly selected cohort of 450 lumbar spinal stenosis patients, with or without spondylolisthesis, who underwent surgery between 2007 and 2013. Results are presented, dichotomised by HADS score (score ≥8 indicating psychologically impaired) and in a Four Quadrants Model integrating functional outcomes and perceived recovery separately for psychologically impaired and non-impaired cases.</p><p><strong>Results: </strong>Among the 147 included patients, 32 (22%) exhibited anxiety and/or depression (impaired cases). Satisfactory outcome (perceived recovery) was reported in 29.0% of the impaired cases and 78.3% of the non-impaired cases (p < 0.001). The mean postoperative functionality score of the impaired cases was 42.46 ± 16.24, in contrast to 18.48 ± 18.25 for the non-impaired cases (p < 0.001). In the impaired group, only 12.5% achieved both a good functional outcome (ODI ≤24) and satisfactory perceived recovery, compared with 58.4% in the non-impaired group.</p><p><strong>Discussion and conclusion: </strong>Patients reporting anxiety and/or depression demonstrate an inferior long-term outcome after spinal stenosis surgery compared to non-impaired patients. This clinically relevant difference underscores the importance of addressing depression and anxiety in preoperative counselling to optimize patient satisfaction and functional outcomes.</p>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416550/pdf/","citationCount":"0","resultStr":"{\"title\":\"Mental state as a predictor of outcome in spinal stenosis surgery: Four quadrants model integrating patient satisfaction and functional outcome.\",\"authors\":\"Judith van Grafhorst, Wouter van Furth, Carmen Vleggeert-Lankamp\",\"doi\":\"10.1016/j.bas.2024.103902\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Mental status, characterised by anxiety and depression, significantly influences physical well-being, particularly in patients with spinal stenosis symptoms.</p><p><strong>Research question: </strong>The prevalence of depression and anxiety in our cohort. The correlation between psychological distress and physical outcome after surgery, including postoperative recovery and satisfaction.</p><p><strong>Materials and methods: </strong>Questionnaires evaluating anxiety and depression (HADS), functionality (ODI), quality of life (EQ-5D), and perceived recovery (Likert-scale) were sent to a randomly selected cohort of 450 lumbar spinal stenosis patients, with or without spondylolisthesis, who underwent surgery between 2007 and 2013. Results are presented, dichotomised by HADS score (score ≥8 indicating psychologically impaired) and in a Four Quadrants Model integrating functional outcomes and perceived recovery separately for psychologically impaired and non-impaired cases.</p><p><strong>Results: </strong>Among the 147 included patients, 32 (22%) exhibited anxiety and/or depression (impaired cases). Satisfactory outcome (perceived recovery) was reported in 29.0% of the impaired cases and 78.3% of the non-impaired cases (p < 0.001). The mean postoperative functionality score of the impaired cases was 42.46 ± 16.24, in contrast to 18.48 ± 18.25 for the non-impaired cases (p < 0.001). In the impaired group, only 12.5% achieved both a good functional outcome (ODI ≤24) and satisfactory perceived recovery, compared with 58.4% in the non-impaired group.</p><p><strong>Discussion and conclusion: </strong>Patients reporting anxiety and/or depression demonstrate an inferior long-term outcome after spinal stenosis surgery compared to non-impaired patients. This clinically relevant difference underscores the importance of addressing depression and anxiety in preoperative counselling to optimize patient satisfaction and functional outcomes.</p>\",\"PeriodicalId\":72443,\"journal\":{\"name\":\"Brain & spine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-09-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416550/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Brain & spine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.bas.2024.103902\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brain & spine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.bas.2024.103902","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Mental state as a predictor of outcome in spinal stenosis surgery: Four quadrants model integrating patient satisfaction and functional outcome.
Introduction: Mental status, characterised by anxiety and depression, significantly influences physical well-being, particularly in patients with spinal stenosis symptoms.
Research question: The prevalence of depression and anxiety in our cohort. The correlation between psychological distress and physical outcome after surgery, including postoperative recovery and satisfaction.
Materials and methods: Questionnaires evaluating anxiety and depression (HADS), functionality (ODI), quality of life (EQ-5D), and perceived recovery (Likert-scale) were sent to a randomly selected cohort of 450 lumbar spinal stenosis patients, with or without spondylolisthesis, who underwent surgery between 2007 and 2013. Results are presented, dichotomised by HADS score (score ≥8 indicating psychologically impaired) and in a Four Quadrants Model integrating functional outcomes and perceived recovery separately for psychologically impaired and non-impaired cases.
Results: Among the 147 included patients, 32 (22%) exhibited anxiety and/or depression (impaired cases). Satisfactory outcome (perceived recovery) was reported in 29.0% of the impaired cases and 78.3% of the non-impaired cases (p < 0.001). The mean postoperative functionality score of the impaired cases was 42.46 ± 16.24, in contrast to 18.48 ± 18.25 for the non-impaired cases (p < 0.001). In the impaired group, only 12.5% achieved both a good functional outcome (ODI ≤24) and satisfactory perceived recovery, compared with 58.4% in the non-impaired group.
Discussion and conclusion: Patients reporting anxiety and/or depression demonstrate an inferior long-term outcome after spinal stenosis surgery compared to non-impaired patients. This clinically relevant difference underscores the importance of addressing depression and anxiety in preoperative counselling to optimize patient satisfaction and functional outcomes.