Ogaban Francis, Coffman Alex, Glass Natalie, Igram Cassim, Pugely Andrew, Olinger Catherine
Department of Orthopedics and Rehabilitation, University of Iowa Hospitals & Clinics, 200 Hawkins Drive Iowa City, IA 52242, USA.
N Am Spine Soc J. 2024 Jul 20;19:100527. doi: 10.1016/j.xnsj.2024.100527. eCollection 2024 Sep.
Recent studies suggest that better outcomes in work productivity following spine surgery eventually offset the higher cost of treatment. By analyzing preoperative and postoperative changes in work productivity, studies can determine if surgery is cost-effective and give patients valuable information about treatment. Prior studies reviewing outcomes in work performance after spine surgery have largely excluded patients on workers' compensation from the overall cost analysis.
A retrospective review of 92 eligible patients was conducted. Evaluation of the EHR identified presenteeism and absenteeism from designated work restrictions. Statistical analyses were conducted using JMP Pro 17.
About 84 (83%) spinal surgery cases were able to return to work, 60 (59%) were able to return to work with no restrictions, 26 (26%) received permanent work restrictions, and 12 (12%) were still undergoing treatment. 86 (85%) experienced presenteeism and 99 (98%) experienced absenteeism. Of the cases that were able to return to work without permanent work restrictions, the mean presenteeism length postoperatively was 287.4 days (median 191 days) and the mean absenteeism length postoperatively was 232.5 days (median 142 days). 72 patients were identified as having sedentary or nonsedentary labor. After excluding outliers, the average return-to-work length was 988.62 days for patients with sedentary employment types and 952.15 days for patients with nonsedentary employment types (p=.116).
Following spinal surgery, our worker's compensation patient population's return-to-work rate was at an average of 232.5 days (median of 142 days) for 83% of patients included in this study. This exhibited worse outcomes than a previous study's measurement excluding worker's compensation patients. Presenteeism length within our population contributed more to decreased work productivity postoperatively than absenteeism length. Our results found no significant difference in return-to-work length between patients with sedentary and nonsedentary employment types.
近期研究表明，脊柱手术后工作效率的改善最终会抵消较高的治疗成本。通过分析术前和术后工作效率的变化，研究可以确定手术是否具有成本效益，并为患者提供有关治疗的有价值信息。之前回顾脊柱手术后工作表现结果的研究在总体成本分析中大多排除了领取工伤赔偿的患者。
对92例符合条件的患者进行了回顾性研究。通过电子健康记录（EHR）评估确定因指定工作限制导致的出勤主义和旷工情况。使用JMP Pro 17进行统计分析。
约84例（83%）脊柱手术患者能够重返工作岗位，60例（59%）能够无限制地重返工作岗位，26例（26%）接受了永久性工作限制，12例（12%）仍在接受治疗。86例（85%）出现出勤主义，99例（98%）出现旷工。在能够无永久性工作限制重返工作岗位的病例中，术后出勤主义的平均时长为287.4天（中位数191天），术后旷工的平均时长为232.5天（中位数142天）。72例患者被确定从事久坐或非久坐工作。排除异常值后，久坐工作类型患者的平均重返工作时长为988.62天，非久坐工作类型患者为952.15天（p = 0.116）。
脊柱手术后，本研究中纳入的83%领取工伤赔偿的患者人群平均重返工作时长为232.5天（中位数142天）。这一结果比之前一项排除工伤赔偿患者的研究测量结果更差。本研究人群中出勤主义时长对术后工作效率下降的影响比旷工时长更大。我们的结果发现，久坐和非久坐工作类型患者的重返工作时长没有显著差异。
