Department of Orthopaedic Surgery and Spinal Surgery, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
University of Tokyo Spine Group (UTSG), 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Eur Spine J. 2021 May;30(5):1226-1234. doi: 10.1007/s00586-021-06815-2. Epub 2021 Mar 20.
To elucidate the minimum clinically important change (MCIC) of the physical component summary (PCS) of the Short Form-12, Oswestry Disability Index (ODI), EuroQOL-5 dimensions (EQ-5D), and the Core Outcome Measures Index (COMI) in patients aged ≥ 75 years undergoing lumbar spine surgery.
We retrospectively reviewed patients aged ≥ 75 years with degenerative lumbar spine disease who underwent lumbar spine decompression or fusion surgery within three levels between April 2017 and June 2018. We also evaluated patients aged < 75 years in the same period as reference. We evaluated the baseline and postoperative PCS, ODI, EQ-5D, and COMI scores. Patients were asked to answer an anchor question regarding health transition for MCICs using the anchor-based method.
A total of 247 patients aged ≥ 75 years and 398 patients aged < 75 years were included for analysis. Of patients aged ≥ 75 years, 83.4% showed at least "somewhat improved" outcomes, while 91.0% of patients aged < 75 years reported this outcome. PCS change score was not adequately correlated to health transition in patients aged ≥ 75 years. Receiver operating characteristic curve analyses revealed MCICs of 17.8 for ODI, 0.18 for EQ-5D, and 1.6 for COMI in patients aged ≥ 75 years, and 12.7 for ODI, 0.19 for EQ-5D, and 2.3 for COMI in patients aged < 75 years.
In patients aged ≥ 75 years, PCS may not be feasible for evaluation of health transition. The MCIC value for ODI score was higher and that for EQ-5D/COMI score was lower in patients aged ≥ 75 years, compared with those in patients aged < 75 years.
阐明接受腰椎减压或融合手术的年龄≥75 岁患者的简明健康量表 12 项（SF-12）物理成分摘要（PCS）、Oswestry 功能障碍指数（ODI）、欧洲五维健康量表（EQ-5D）和核心结局测量指标（COMI）的最小临床重要变化（MCIC）。
我们回顾性分析了 2017 年 4 月至 2018 年 6 月期间行腰椎减压或融合手术且手术涉及三个节段以内的年龄≥75 岁退行性腰椎疾病患者，同时纳入了同期年龄<75 岁的患者作为参考。我们评估了患者的基线和术后 PCS、ODI、EQ-5D 和 COMI 评分。采用基于锚定的方法，让患者回答关于健康变化的锚定问题，以此来评估 MCIC。
共纳入 247 例年龄≥75 岁和 398 例年龄<75 岁的患者进行分析。在年龄≥75 岁的患者中，83.4%的患者报告至少“有所改善”的结局，而 91.0%的年龄<75 岁的患者报告了这一结果。年龄≥75 岁的患者的 PCS 变化评分与健康变化无显著相关性。受试者工作特征曲线分析显示，年龄≥75 岁的患者的 ODI、EQ-5D 和 COMI 的 MCIC 分别为 17.8、0.18 和 1.6，而年龄<75 岁的患者的 ODI、EQ-5D 和 COMI 的 MCIC 分别为 12.7、0.19 和 2.3。
在年龄≥75 岁的患者中，PCS 可能无法评估健康变化。与年龄<75 岁的患者相比，年龄≥75 岁的患者的 ODI 评分的 MCIC 值更高，而 EQ-5D/COMI 评分的 MCIC 值更低。
