Gepstein R, Arinzon Z, Adunsky A, Folman Y
Spinal Care Unit, Sapir Medical Center, Meir General Hospital, Kfar-Saba, Israel.
Spinal Cord. 2006 Jul;44(7):427-31. doi: 10.1038/sj.sc.3101857. Epub 2005 Nov 22.
Retrospective cohort examination.
Data on expectations and satisfaction rates in elderly patients operated for lumbar spinal stenosis (LSS) are limited. The present study aimed to investigate these issues as well as the factors that might affect them.
A university affiliated hospital.
A follow-up study of 367 consecutive patients aged 65 years and older (mean age 71.4 years), who underwent surgery for degenerative LSS between 1990 and 2000. Data collection included patients' preoperative expectation, demographic data, body mass index, operative risk, duration of symptoms, clinical presentation and patients' satisfaction on follow-up, pain level, activities of daily living level and walking ability. Data were recorded before operation and on follow-up. Preoperative and follow-up data were analyzed by univariate and multivariable models.
The response rate on follow-up was 81% (298 patients). A logistic regression analysis showed that advanced age, male gender and high education level were independently associated with positive expectations, while a great number of covariates were associated with patients' satisfaction. High patients' expectations were positively interrelated with satisfaction (r=0.332, P<0.001).
In the elderly, preoperative expectations reasonably predict their postoperative satisfaction rate. It is suggested that a greater effort should be made to narrow the gaps between expectations and satisfaction, perhaps by providing more accurate preoperative information data regarding the outcomes of planned surgery.
回顾性队列研究。
关于接受腰椎管狭窄症（LSS）手术的老年患者的期望和满意率的数据有限。本研究旨在调查这些问题以及可能影响它们的因素。
一家大学附属医院。
对1990年至2000年间连续接受退行性LSS手术的367例65岁及以上（平均年龄71.4岁）患者进行随访研究。数据收集包括患者的术前期望、人口统计学数据、体重指数、手术风险、症状持续时间、临床表现以及患者随访时的满意度、疼痛程度、日常生活水平和行走能力。数据在手术前和随访时记录。术前和随访数据通过单变量和多变量模型进行分析。
随访应答率为81%（298例患者）。逻辑回归分析表明，高龄、男性和高学历与积极期望独立相关，而大量协变量与患者满意度相关。患者的高期望与满意度呈正相关（r = 0.332，P < 0.001）。
在老年人中，术前期望能合理预测其术后满意率。建议或许通过提供关于计划手术结果的更准确术前信息数据，做出更大努力来缩小期望与满意度之间的差距。
