Vall D'Hebron Institute of Research (VHIR), Barcelona, Spain.
Orthopaedics and Traumatology Department, Hospital Universitario Donostia, Paseo del Dr. Begiristain 109, 20014, San Sebastián, Spain.
Eur Spine J. 2021 May;30(5):1235-1246. doi: 10.1007/s00586-021-06816-1. Epub 2021 Mar 22.
For adult spinal deformity (ASD) patients receiving operative (op) and non-operative (non-op) treatment, the relationship between HRQoL measures, complications and self-reported satisfaction remains unclear. The objective of this analysis is to study nonlinear association dynamics between ASD patient satisfaction, HRQoL, and complications over a two-year follow-up period.
From a prospective multicenter international adult spinal deformity database, all patients with 2-year follow-up data on satisfaction (21st question of SRS-22r) were identified and included. A total of 12 LOESS (local polynomial fit) regressions were performed between patient satisfaction (SRS22 item 21) and HRQoL measures (ODI, SF36PCS and SRS22 subtotal) interacting with surgery at baseline, 6 months and 1 and 2 years of follow-up.
A total of 856 patients (527 op and 329 non-op) were included. At baseline, satisfaction was lower for patients scheduled for surgery even when HRQL was similar to those elected for conservative treatment. The nonlinear correlations showed that for similar PROMs, op patients reached higher satisfaction levels during follow-up, especially at six months. In fact, at six months operated patients with a deterioration of their initial PROMs had some improvement in their satisfaction, which could not be further observed at the end of follow-up.
Satisfaction does not correlate well with other PROMs, and it might be subject to other external factors not directly related to treatment. Even if patient satisfaction is important in evaluating well-being and patient's experience with medical care, it should not be considered as an isolated proxy to measure quality of treatment.
对于接受手术（op）和非手术（non-op）治疗的成人脊柱畸形（ASD）患者，HRQoL 测量、并发症和自我报告满意度之间的关系尚不清楚。本分析的目的是研究 ASD 患者满意度、HRQoL 和并发症在两年随访期间的非线性关联动态。
从一个前瞻性多中心国际成人脊柱畸形数据库中，确定并纳入所有有 2 年满意度随访数据（SRS-22r 的第 21 个问题）的患者。共进行了 12 次局部多项式拟合（LOESS）回归，在基线、6 个月和 1 年和 2 年随访时，将患者满意度（SRS22 项目 21）与 HRQoL 测量（ODI、SF36PCS 和 SRS22 总分）进行交互作用。
共纳入 856 例患者（527 例手术和 329 例非手术）。基线时，即使 HRQL 与选择保守治疗的患者相似，计划手术的患者满意度较低。非线性相关性表明，对于相似的 PROMs，接受手术的患者在随访期间达到更高的满意度水平，尤其是在 6 个月时。事实上，在 6 个月时，初始 PROMs 恶化的手术患者的满意度有所改善，而在随访结束时则无法进一步观察到这种改善。
满意度与其他 PROMs 相关性不佳，可能受到与治疗无关的其他外部因素的影响。尽管患者满意度在评估幸福感和患者对医疗护理的体验方面很重要，但它不应该被视为衡量治疗质量的孤立指标。
