E Kung Justin, Gauthier Chase, Bakaes Yianni, Spitnale Michael, A Bidwell Richard, G Edelman David, C Ventresca Heidi, Jackson J Benjamin, Cui Shari, Grabowski Gregory
Orthopedic Surgery, Prisma Health Midlands, University of South Carolina School of Medicine, Columbia, USA.
Spine Surg Relat Res. 2024 Oct 5;9(2):237-243. doi: 10.22603/ssrr.2024-0177. eCollection 2025 Mar 27.
This study aims to determine whether Patient-Reported Outcomes Measurement Information System (PROMIS) domain scores can predict elective spine surgery within 1 year of initial clinic evaluation.
A retrospective query for all new patient spine clinic visits with diagnosis codes related to lower back pain was carried out at a single academic institution. A chart review was conducted to collect sociodemographic variables, clinic visit details, and PROMIS domain scores (PF [Physical Function], PI [Pain Interference], Depression, and Global Health-Physical and Global Health-Mental). Patients were divided into Surgery and No Surgery, and for time to surgery, a subanalysis was also carried out.
Overall, 116 (8.4%) of 1,387 new patients underwent surgery within 1 year. Race, Surgeon vs. Advanced Practice Provider (APP), and whether advanced imaging (MRI or CT myelogram) was available for interpretation were statistically associated with undergoing surgery. Patients in the Surgery group had statistically significant worse PROMIS scores in all domains when compared with the No Surgery group, and PROMIS PI was additionally associated with Time to Surgery. Multivariate analysis identified PROMIS PI, race, presence of advanced imaging interpretation, and Surgeon vs. APP as independent predictors of Surgery vs. No Surgery; however, only race and PROMIS PI were independent predictors of Time to Surgery.
Worse new patient PROMIS PI scores were associated with undergoing surgery within one year of initial evaluation. To determine if PROMIS scores may help in a triage capacity to identify which patients are most appropriate for a surgeon visit versus a nonsurgical provider, further research is needed, thereby improving the efficiency of surgical care delivery.
本研究旨在确定患者报告结局测量信息系统（PROMIS）领域得分是否能够在首次临床评估后的1年内预测择期脊柱手术。
在一家学术机构对所有新的脊柱门诊患者进行回顾性查询，这些患者的诊断代码与下背痛相关。进行病历审查以收集社会人口统计学变量、门诊就诊细节以及PROMIS领域得分（PF[身体功能]、PI[疼痛干扰]、抑郁以及总体健康-身体和总体健康-心理）。患者被分为手术组和非手术组，对于手术时间，还进行了亚分析。
总体而言，1387名新患者中有116名（8.4%）在1年内接受了手术。种族、外科医生与高级执业提供者（APP）以及是否有高级影像学检查（MRI或CT脊髓造影）可供解读与接受手术在统计学上相关。与非手术组相比，手术组患者在所有领域的PROMIS得分在统计学上显著更差，并且PROMIS PI还与手术时间相关。多变量分析确定PROMIS PI、种族、是否有高级影像学解读以及外科医生与APP是手术与非手术的独立预测因素；然而，只有种族和PROMIS PI是手术时间的独立预测因素。
新患者较差的PROMIS PI得分与初次评估后1年内接受手术相关。为了确定PROMIS得分是否有助于在分诊时识别哪些患者最适合看外科医生而非非手术治疗提供者，需要进一步研究，从而提高手术治疗的效率。
