Predictors of Health-Related Quality-of-Life After Complex Adult Spinal Deformity Surgery: A Scoli-RISK-1 Secondary Analysis

Leah Y Carreon; Steven D Glassman; Christopher I Shaffrey; Michael G Fehlings; Benny Dahl; Christopher P Ames; Yukihiro Matsuyama; Yong Qiu; Hossein Mehdian; Kenneth M C Cheung; Frank J Schwab; Ferran Pellisé; Khaled M Kebaish; Lawrence G Lenke

doi:10.1016/j.jspd.2016.11.001

Predictors of Health-Related Quality-of-Life After Complex Adult Spinal Deformity Surgery: A Scoli-RISK-1 Secondary Analysis

Leah Y Carreon, Steven D Glassman, Christopher I Shaffrey, Michael G Fehlings, Benny Dahl, Christopher P Ames, Yukihiro Matsuyama, Yong Qiu, Hossein Mehdian, Kenneth M C Cheung, Frank J Schwab, Ferran Pellisé, Khaled M Kebaish, Lawrence G Lenke

Afdeling for Led- og Knoglekirurgi

26 Citationer (Scopus)

Abstract

STUDY DESIGN: Longitudinal cohort.

OBJECTIVES: To identify variables that predict 2-year Short Form-36 Physical Composite Summary Score (SF-36PCS) and the Scoliosis Research Society-22R (SRS22-R) Total score after surgery for complex adult spinal deformity.

SUMMARY OF BACKGROUND DATA: Increasingly, treatment effectiveness is assessed by the extent to which the procedure improves a patient's health-related quality of life (HRQOL). This is especially true in patients with complex adult spinal deformity.

METHODS: The data set from the Scoli-Risk-1 study was queried for patients with complete 2-year SF-36 and SRS-22R. Regression analysis was performed to determine predictors of 2-year SF-36PCS and SRS-22R Total scores. Factors included were sex, age, smoking status, body mass index, American Society of Anesthesiologists (ASA) grade, Lower Extremity Motor Score improvement, indication for surgery, preoperative and 2-year maximum coronal Cobb angles, number of prior spine surgeries, number of three-column osteotomies, number of surgical levels, number of surgical stages, lowest instrumented level, presence and type of neurologic complication, and number of reported serious adverse events.

RESULTS: Of 272 cases enrolled, 206 (76%) cases were included in this analysis, 143 (69%) females, and mean age of 57.69 years. Factors that were significantly associated with of 2-year SF-36PCS were age (p < .001), ASA grade (p < .001), maximum preoperative Cobb angle (p = .007), number of three-column osteotomies (p = .049) and type of neurologic complication (p = .068). Factors predictive of 2-year SRS-22R Total scores were maximum preoperative Cobb angle (p = .001) and the number of serious adverse events (p = .071).

CONCLUSIONS: Factors predictive of lower 2-year HRQOLs after surgery for complex adult spinal deformity were older age, higher ASA grade, larger preoperative Cobb angle, larger numbers of three-column osteotomies, and the occurrence of both neurologic and nonneurologic complications. Most of these factors are beyond the control of surgeons. Still, surgeons should medically optimize a patient prior to surgery to minimize the risk of complications and offer the best chance of improving a patient's quality of life.

LEVEL OF EVIDENCE: Level II. Prospective cohort.

Originalsprog	Engelsk
Tidsskrift	Spine Deformity
Vol/bind	5
Udgave nummer	2
Sider (fra-til)	139-144
Antal sider	6
DOI	https://doi.org/10.1016/j.jspd.2016.11.001
Status	Udgivet - mar. 2017

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10.1016/j.jspd.2016.11.001

Citationsformater

Carreon, L. Y., Glassman, S. D., Shaffrey, C. I., Fehlings, M. G., Dahl, B., Ames, C. P., Matsuyama, Y., Qiu, Y., Mehdian, H., Cheung, K. M. C., Schwab, F. J., Pellisé, F., Kebaish, K. M., & Lenke, L. G. (2017). Predictors of Health-Related Quality-of-Life After Complex Adult Spinal Deformity Surgery: A Scoli-RISK-1 Secondary Analysis. Spine Deformity, 5(2), 139-144. https://doi.org/10.1016/j.jspd.2016.11.001

Carreon, LY, Glassman, SD, Shaffrey, CI, Fehlings, MG, Dahl, B, Ames, CP, Matsuyama, Y, Qiu, Y, Mehdian, H, Cheung, KMC, Schwab, FJ, Pellisé, F, Kebaish, KM & Lenke, LG 2017, 'Predictors of Health-Related Quality-of-Life After Complex Adult Spinal Deformity Surgery: A Scoli-RISK-1 Secondary Analysis', Spine Deformity, bind 5, nr. 2, s. 139-144. https://doi.org/10.1016/j.jspd.2016.11.001

@article{65b86c8fd9d5425aafcc8cbb0a90ac9d,

title = "Predictors of Health-Related Quality-of-Life After Complex Adult Spinal Deformity Surgery: A Scoli-RISK-1 Secondary Analysis",

abstract = "STUDY DESIGN: Longitudinal cohort.OBJECTIVES: To identify variables that predict 2-year Short Form-36 Physical Composite Summary Score (SF-36PCS) and the Scoliosis Research Society-22R (SRS22-R) Total score after surgery for complex adult spinal deformity.SUMMARY OF BACKGROUND DATA: Increasingly, treatment effectiveness is assessed by the extent to which the procedure improves a patient's health-related quality of life (HRQOL). This is especially true in patients with complex adult spinal deformity.METHODS: The data set from the Scoli-Risk-1 study was queried for patients with complete 2-year SF-36 and SRS-22R. Regression analysis was performed to determine predictors of 2-year SF-36PCS and SRS-22R Total scores. Factors included were sex, age, smoking status, body mass index, American Society of Anesthesiologists (ASA) grade, Lower Extremity Motor Score improvement, indication for surgery, preoperative and 2-year maximum coronal Cobb angles, number of prior spine surgeries, number of three-column osteotomies, number of surgical levels, number of surgical stages, lowest instrumented level, presence and type of neurologic complication, and number of reported serious adverse events.RESULTS: Of 272 cases enrolled, 206 (76%) cases were included in this analysis, 143 (69%) females, and mean age of 57.69 years. Factors that were significantly associated with of 2-year SF-36PCS were age (p < .001), ASA grade (p < .001), maximum preoperative Cobb angle (p = .007), number of three-column osteotomies (p = .049) and type of neurologic complication (p = .068). Factors predictive of 2-year SRS-22R Total scores were maximum preoperative Cobb angle (p = .001) and the number of serious adverse events (p = .071).CONCLUSIONS: Factors predictive of lower 2-year HRQOLs after surgery for complex adult spinal deformity were older age, higher ASA grade, larger preoperative Cobb angle, larger numbers of three-column osteotomies, and the occurrence of both neurologic and nonneurologic complications. Most of these factors are beyond the control of surgeons. Still, surgeons should medically optimize a patient prior to surgery to minimize the risk of complications and offer the best chance of improving a patient's quality of life.LEVEL OF EVIDENCE: Level II. Prospective cohort.",

keywords = "Journal Article",

author = "Carreon, {Leah Y} and Glassman, {Steven D} and Shaffrey, {Christopher I} and Fehlings, {Michael G} and Benny Dahl and Ames, {Christopher P} and Yukihiro Matsuyama and Yong Qiu and Hossein Mehdian and Cheung, {Kenneth M C} and Schwab, {Frank J} and Ferran Pellis{\'e} and Kebaish, {Khaled M} and Lenke, {Lawrence G}",

year = "2017",

month = mar,

doi = "10.1016/j.jspd.2016.11.001",

language = "English",

volume = "5",

pages = "139--144",

journal = "Spine Deformity",

issn = "2212-1358",

publisher = "Elsevier BV",

number = "2",

}

TY - JOUR

T1 - Predictors of Health-Related Quality-of-Life After Complex Adult Spinal Deformity Surgery

T2 - A Scoli-RISK-1 Secondary Analysis

AU - Carreon, Leah Y

AU - Glassman, Steven D

AU - Shaffrey, Christopher I

AU - Fehlings, Michael G

AU - Dahl, Benny

AU - Ames, Christopher P

AU - Matsuyama, Yukihiro

AU - Qiu, Yong

AU - Mehdian, Hossein

AU - Cheung, Kenneth M C

AU - Schwab, Frank J

AU - Pellisé, Ferran

AU - Kebaish, Khaled M

AU - Lenke, Lawrence G

PY - 2017/3

Y1 - 2017/3

N2 - STUDY DESIGN: Longitudinal cohort.OBJECTIVES: To identify variables that predict 2-year Short Form-36 Physical Composite Summary Score (SF-36PCS) and the Scoliosis Research Society-22R (SRS22-R) Total score after surgery for complex adult spinal deformity.SUMMARY OF BACKGROUND DATA: Increasingly, treatment effectiveness is assessed by the extent to which the procedure improves a patient's health-related quality of life (HRQOL). This is especially true in patients with complex adult spinal deformity.METHODS: The data set from the Scoli-Risk-1 study was queried for patients with complete 2-year SF-36 and SRS-22R. Regression analysis was performed to determine predictors of 2-year SF-36PCS and SRS-22R Total scores. Factors included were sex, age, smoking status, body mass index, American Society of Anesthesiologists (ASA) grade, Lower Extremity Motor Score improvement, indication for surgery, preoperative and 2-year maximum coronal Cobb angles, number of prior spine surgeries, number of three-column osteotomies, number of surgical levels, number of surgical stages, lowest instrumented level, presence and type of neurologic complication, and number of reported serious adverse events.RESULTS: Of 272 cases enrolled, 206 (76%) cases were included in this analysis, 143 (69%) females, and mean age of 57.69 years. Factors that were significantly associated with of 2-year SF-36PCS were age (p < .001), ASA grade (p < .001), maximum preoperative Cobb angle (p = .007), number of three-column osteotomies (p = .049) and type of neurologic complication (p = .068). Factors predictive of 2-year SRS-22R Total scores were maximum preoperative Cobb angle (p = .001) and the number of serious adverse events (p = .071).CONCLUSIONS: Factors predictive of lower 2-year HRQOLs after surgery for complex adult spinal deformity were older age, higher ASA grade, larger preoperative Cobb angle, larger numbers of three-column osteotomies, and the occurrence of both neurologic and nonneurologic complications. Most of these factors are beyond the control of surgeons. Still, surgeons should medically optimize a patient prior to surgery to minimize the risk of complications and offer the best chance of improving a patient's quality of life.LEVEL OF EVIDENCE: Level II. Prospective cohort.

AB - STUDY DESIGN: Longitudinal cohort.OBJECTIVES: To identify variables that predict 2-year Short Form-36 Physical Composite Summary Score (SF-36PCS) and the Scoliosis Research Society-22R (SRS22-R) Total score after surgery for complex adult spinal deformity.SUMMARY OF BACKGROUND DATA: Increasingly, treatment effectiveness is assessed by the extent to which the procedure improves a patient's health-related quality of life (HRQOL). This is especially true in patients with complex adult spinal deformity.METHODS: The data set from the Scoli-Risk-1 study was queried for patients with complete 2-year SF-36 and SRS-22R. Regression analysis was performed to determine predictors of 2-year SF-36PCS and SRS-22R Total scores. Factors included were sex, age, smoking status, body mass index, American Society of Anesthesiologists (ASA) grade, Lower Extremity Motor Score improvement, indication for surgery, preoperative and 2-year maximum coronal Cobb angles, number of prior spine surgeries, number of three-column osteotomies, number of surgical levels, number of surgical stages, lowest instrumented level, presence and type of neurologic complication, and number of reported serious adverse events.RESULTS: Of 272 cases enrolled, 206 (76%) cases were included in this analysis, 143 (69%) females, and mean age of 57.69 years. Factors that were significantly associated with of 2-year SF-36PCS were age (p < .001), ASA grade (p < .001), maximum preoperative Cobb angle (p = .007), number of three-column osteotomies (p = .049) and type of neurologic complication (p = .068). Factors predictive of 2-year SRS-22R Total scores were maximum preoperative Cobb angle (p = .001) and the number of serious adverse events (p = .071).CONCLUSIONS: Factors predictive of lower 2-year HRQOLs after surgery for complex adult spinal deformity were older age, higher ASA grade, larger preoperative Cobb angle, larger numbers of three-column osteotomies, and the occurrence of both neurologic and nonneurologic complications. Most of these factors are beyond the control of surgeons. Still, surgeons should medically optimize a patient prior to surgery to minimize the risk of complications and offer the best chance of improving a patient's quality of life.LEVEL OF EVIDENCE: Level II. Prospective cohort.

KW - Journal Article

U2 - 10.1016/j.jspd.2016.11.001

DO - 10.1016/j.jspd.2016.11.001

M3 - Journal article

C2 - 28259266

SN - 2212-1358

VL - 5

SP - 139

EP - 144

JO - Spine Deformity

JF - Spine Deformity

IS - 2

ER -

Predictors of Health-Related Quality-of-Life After Complex Adult Spinal Deformity Surgery: A Scoli-RISK-1 Secondary Analysis

Abstract

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