Lynch Conor P, Cha Elliot D K, Jadczak Caroline N, Mohan Shruthi, Geoghegan Cara E, Singh Kern
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
Neurospine. 2022 Jun;19(2):307-314. doi: 10.14245/ns.2040706.353. Epub 2022 Jan 2.
Patient-Reported Outcomes Measurement Information System (PROMIS) is a validated tool for assessing patient-reported outcomes in spine surgery. However, PROMIS is vulnerable to nonresponse bias. The purpose of this study is to characterize differences in patient-reported outcome measure scores between patients who do and do not complete PROMIS physical function (PF) surveys following lumbar spine surgery.
A prospectively maintained database was retrospectively reviewed for primary, elective lumbar spine procedures from 2015 to 2019. Outcome measures for Patient Health Questionnaire-9 (PHQ-9), visual analogue scale (VAS) back & leg, Oswestry Disability Index (ODI), and 12-item Short Form health survey physical composite summary (SF-12 PCS) were recorded at both preoperative and postoperative (6 weeks, 12 weeks, 6 months, 1 year, 2 years) timepoints. Completion rates for PROMIS PF surveys were recorded and patients were categorized into groups based on completion. Differences in mean scores at each timepoint between groups was determined.
Eight hundred nine patients were included with an average age of 48.1 years. No significant differences were observed for all outcome measures between PROMIS completion groups preoperatively. Postoperative PHQ-9, VAS back, VAS leg, and ODI scores differed significantly between groups through 1 year (all p < 0.05). SF-12 PCS differed significantly only at 6 weeks (p = 0.003).
Patients who did not complete PROMIS PF surveys had significantly poorer outcomes than those that did in terms of postoperative depressive symptoms, pain, and disability. This suggests that patients completing PROMIS questionnaires may represent a healthier cohort than the overall lumbar spine population.
患者报告结局测量信息系统（PROMIS）是一种用于评估脊柱手术患者报告结局的经过验证的工具。然而，PROMIS易受无应答偏倚的影响。本研究的目的是描述腰椎手术后完成和未完成PROMIS身体功能（PF）调查的患者在患者报告结局测量得分上的差异。
对一个前瞻性维护的数据库进行回顾性分析，纳入2015年至2019年的原发性择期腰椎手术病例。记录患者健康问卷-9（PHQ-9）、视觉模拟量表（VAS）背痛和腿痛、奥斯威斯利残疾指数（ODI）以及12项简明健康调查身体综合汇总（SF-12 PCS）在术前和术后（6周、12周、6个月、1年、2年）时间点的结果测量值。记录PROMIS PF调查的完成率，并根据完成情况将患者分为不同组。确定各时间点两组之间平均得分的差异。
纳入809例患者，平均年龄48.1岁。术前PROMIS完成组之间在所有结局测量指标上均未观察到显著差异。术后PHQ-9、VAS背痛、VAS腿痛和ODI评分在1年内两组之间存在显著差异（均p<0.05）。SF-12 PCS仅在6周时存在显著差异（p = 0.003）。
未完成PROMIS PF调查的患者在术后抑郁症状、疼痛和残疾方面的结局明显比完成调查的患者差。这表明完成PROMIS问卷的患者可能比整个腰椎手术患者群体更健康。
