Health-Related Quality of Life Scores Underestimate the Impact of Major Complications in Lumbar Degenerative Scoliosis Surgery
Study Design Retrospective cohort. Objective To examine Charlson Comorbidity Index (CCMI) as a marker for deterioration in health status not reflected in standard Health Related Quality of Life (HRQOL) measures. Summary of Background Data HRQOL has become a primary metric for assessing outcomes foll...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Glassman, Steven D. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2018 |
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| Schlagwörter: |
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| Anmerkung: |
© Scoliosis Research Society 2017 |
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| Übergeordnetes Werk: |
Enthalten in: Spine deformity - Amsterdam [u.a.] : Elsevier, 2013, 6(2018), 1 vom: Jan., Seite 67-71 |
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| Übergeordnetes Werk: |
volume:6 ; year:2018 ; number:1 ; month:01 ; pages:67-71 |
| Links: |
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| DOI / URN: |
10.1016/j.jspd.2017.05.003 |
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SPR038871734 |
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| 520 | |a Study Design Retrospective cohort. Objective To examine Charlson Comorbidity Index (CCMI) as a marker for deterioration in health status not reflected in standard Health Related Quality of Life (HRQOL) measures. Summary of Background Data HRQOL has become a primary metric for assessing outcomes following spinal deformity surgery. However, studies have reported limited impact of complications on postoperative HRQOL outcomes. Methods We examined serial CCMI, complications, and HRQOL outcomes for 138 adult lumbar deformity patients treated surgically with a minimum two-year follow-up that included 126 females (91%) with a mean age of 59.8 years (range, 40.2–78.5). Patients with no, minor, or major complications were compared at baseline and at one and two years postoperation. Results Minor complications were observed in 26 patients (19%) and major complications in 15 (11%). Major complications included motor deficit (7), deep vein thrombosis (4), and respiratory failure (3). There was no difference in preoperative SF-36 Physical Component Summary or Scoliosis Research Society—22R (SRS-22R) scores among the groups at baseline. Preoperative CCMI was lowest in the No Complication group (3.52 ± 1.70) followed by the Major (4.00 ± 1.13) and Minor Complication groups (4.15 ± 1.71, p = .165). At one year, there was a significantly greater CCMI deterioration in the Major Complication group (0.80 ± 1.01) compared to both the Minor (0.08 ± 0.27) and No Complication groups (0.27 ± 0.47, p < .001). There was no significant difference in SF-36 Physical Component Summary or SRS-22R scores among the three groups. Similar findings were observed at two years. Conclusions Despite similar one- and two-year HRQOL improvement, patients with major complications had greater deterioration in CCMI. As CCMI is predictive of medical and surgical risk, patients who sustained a major complication now carry a greater likelihood of adverse outcomes with future interventions, including any subsequent spinal surgery. Although this increased risk may not alter the patient’s perception of his or her current health status, it may be important, and should be recognized as part of the shared decision-making process. Level of Evidence Level II, high-quality prognostic study. | ||
| 650 | 4 | |a Lumbar scoliosis |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Adult spinal deformity |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Complications |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Patient-reported outcomes |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Prospective cohort |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Bridwell, Keith H. |4 aut | |
| 700 | 1 | |a Shaffrey, Christopher I. |4 aut | |
| 700 | 1 | |a Edwards, Charles C. |4 aut | |
| 700 | 1 | |a Lurie, Jon D. |4 aut | |
| 700 | 1 | |a Baldus, Christine R. |4 aut | |
| 700 | 1 | |a Carreon, Leah Y. |4 aut | |
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10.1016/j.jspd.2017.05.003 doi (DE-627)SPR038871734 (SPR)j.jspd.2017.05.003-e DE-627 ger DE-627 rakwb eng Glassman, Steven D. verfasserin aut Health-Related Quality of Life Scores Underestimate the Impact of Major Complications in Lumbar Degenerative Scoliosis Surgery 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2017 Study Design Retrospective cohort. Objective To examine Charlson Comorbidity Index (CCMI) as a marker for deterioration in health status not reflected in standard Health Related Quality of Life (HRQOL) measures. Summary of Background Data HRQOL has become a primary metric for assessing outcomes following spinal deformity surgery. However, studies have reported limited impact of complications on postoperative HRQOL outcomes. Methods We examined serial CCMI, complications, and HRQOL outcomes for 138 adult lumbar deformity patients treated surgically with a minimum two-year follow-up that included 126 females (91%) with a mean age of 59.8 years (range, 40.2–78.5). Patients with no, minor, or major complications were compared at baseline and at one and two years postoperation. Results Minor complications were observed in 26 patients (19%) and major complications in 15 (11%). Major complications included motor deficit (7), deep vein thrombosis (4), and respiratory failure (3). There was no difference in preoperative SF-36 Physical Component Summary or Scoliosis Research Society—22R (SRS-22R) scores among the groups at baseline. Preoperative CCMI was lowest in the No Complication group (3.52 ± 1.70) followed by the Major (4.00 ± 1.13) and Minor Complication groups (4.15 ± 1.71, p = .165). At one year, there was a significantly greater CCMI deterioration in the Major Complication group (0.80 ± 1.01) compared to both the Minor (0.08 ± 0.27) and No Complication groups (0.27 ± 0.47, p < .001). There was no significant difference in SF-36 Physical Component Summary or SRS-22R scores among the three groups. Similar findings were observed at two years. Conclusions Despite similar one- and two-year HRQOL improvement, patients with major complications had greater deterioration in CCMI. As CCMI is predictive of medical and surgical risk, patients who sustained a major complication now carry a greater likelihood of adverse outcomes with future interventions, including any subsequent spinal surgery. Although this increased risk may not alter the patient’s perception of his or her current health status, it may be important, and should be recognized as part of the shared decision-making process. Level of Evidence Level II, high-quality prognostic study. Lumbar scoliosis (dpeaa)DE-He213 Adult spinal deformity (dpeaa)DE-He213 Complications (dpeaa)DE-He213 Patient-reported outcomes (dpeaa)DE-He213 Prospective cohort (dpeaa)DE-He213 Bridwell, Keith H. aut Shaffrey, Christopher I. aut Edwards, Charles C. aut Lurie, Jon D. aut Baldus, Christine R. aut Carreon, Leah Y. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 6(2018), 1 vom: Jan., Seite 67-71 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:6 year:2018 number:1 month:01 pages:67-71 https://dx.doi.org/10.1016/j.jspd.2017.05.003 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 6 2018 1 01 67-71 |
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10.1016/j.jspd.2017.05.003 doi (DE-627)SPR038871734 (SPR)j.jspd.2017.05.003-e DE-627 ger DE-627 rakwb eng Glassman, Steven D. verfasserin aut Health-Related Quality of Life Scores Underestimate the Impact of Major Complications in Lumbar Degenerative Scoliosis Surgery 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2017 Study Design Retrospective cohort. Objective To examine Charlson Comorbidity Index (CCMI) as a marker for deterioration in health status not reflected in standard Health Related Quality of Life (HRQOL) measures. Summary of Background Data HRQOL has become a primary metric for assessing outcomes following spinal deformity surgery. However, studies have reported limited impact of complications on postoperative HRQOL outcomes. Methods We examined serial CCMI, complications, and HRQOL outcomes for 138 adult lumbar deformity patients treated surgically with a minimum two-year follow-up that included 126 females (91%) with a mean age of 59.8 years (range, 40.2–78.5). Patients with no, minor, or major complications were compared at baseline and at one and two years postoperation. Results Minor complications were observed in 26 patients (19%) and major complications in 15 (11%). Major complications included motor deficit (7), deep vein thrombosis (4), and respiratory failure (3). There was no difference in preoperative SF-36 Physical Component Summary or Scoliosis Research Society—22R (SRS-22R) scores among the groups at baseline. Preoperative CCMI was lowest in the No Complication group (3.52 ± 1.70) followed by the Major (4.00 ± 1.13) and Minor Complication groups (4.15 ± 1.71, p = .165). At one year, there was a significantly greater CCMI deterioration in the Major Complication group (0.80 ± 1.01) compared to both the Minor (0.08 ± 0.27) and No Complication groups (0.27 ± 0.47, p < .001). There was no significant difference in SF-36 Physical Component Summary or SRS-22R scores among the three groups. Similar findings were observed at two years. Conclusions Despite similar one- and two-year HRQOL improvement, patients with major complications had greater deterioration in CCMI. As CCMI is predictive of medical and surgical risk, patients who sustained a major complication now carry a greater likelihood of adverse outcomes with future interventions, including any subsequent spinal surgery. Although this increased risk may not alter the patient’s perception of his or her current health status, it may be important, and should be recognized as part of the shared decision-making process. Level of Evidence Level II, high-quality prognostic study. Lumbar scoliosis (dpeaa)DE-He213 Adult spinal deformity (dpeaa)DE-He213 Complications (dpeaa)DE-He213 Patient-reported outcomes (dpeaa)DE-He213 Prospective cohort (dpeaa)DE-He213 Bridwell, Keith H. aut Shaffrey, Christopher I. aut Edwards, Charles C. aut Lurie, Jon D. aut Baldus, Christine R. aut Carreon, Leah Y. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 6(2018), 1 vom: Jan., Seite 67-71 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:6 year:2018 number:1 month:01 pages:67-71 https://dx.doi.org/10.1016/j.jspd.2017.05.003 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 6 2018 1 01 67-71 |
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10.1016/j.jspd.2017.05.003 doi (DE-627)SPR038871734 (SPR)j.jspd.2017.05.003-e DE-627 ger DE-627 rakwb eng Glassman, Steven D. verfasserin aut Health-Related Quality of Life Scores Underestimate the Impact of Major Complications in Lumbar Degenerative Scoliosis Surgery 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2017 Study Design Retrospective cohort. Objective To examine Charlson Comorbidity Index (CCMI) as a marker for deterioration in health status not reflected in standard Health Related Quality of Life (HRQOL) measures. Summary of Background Data HRQOL has become a primary metric for assessing outcomes following spinal deformity surgery. However, studies have reported limited impact of complications on postoperative HRQOL outcomes. Methods We examined serial CCMI, complications, and HRQOL outcomes for 138 adult lumbar deformity patients treated surgically with a minimum two-year follow-up that included 126 females (91%) with a mean age of 59.8 years (range, 40.2–78.5). Patients with no, minor, or major complications were compared at baseline and at one and two years postoperation. Results Minor complications were observed in 26 patients (19%) and major complications in 15 (11%). Major complications included motor deficit (7), deep vein thrombosis (4), and respiratory failure (3). There was no difference in preoperative SF-36 Physical Component Summary or Scoliosis Research Society—22R (SRS-22R) scores among the groups at baseline. Preoperative CCMI was lowest in the No Complication group (3.52 ± 1.70) followed by the Major (4.00 ± 1.13) and Minor Complication groups (4.15 ± 1.71, p = .165). At one year, there was a significantly greater CCMI deterioration in the Major Complication group (0.80 ± 1.01) compared to both the Minor (0.08 ± 0.27) and No Complication groups (0.27 ± 0.47, p < .001). There was no significant difference in SF-36 Physical Component Summary or SRS-22R scores among the three groups. Similar findings were observed at two years. Conclusions Despite similar one- and two-year HRQOL improvement, patients with major complications had greater deterioration in CCMI. As CCMI is predictive of medical and surgical risk, patients who sustained a major complication now carry a greater likelihood of adverse outcomes with future interventions, including any subsequent spinal surgery. Although this increased risk may not alter the patient’s perception of his or her current health status, it may be important, and should be recognized as part of the shared decision-making process. Level of Evidence Level II, high-quality prognostic study. Lumbar scoliosis (dpeaa)DE-He213 Adult spinal deformity (dpeaa)DE-He213 Complications (dpeaa)DE-He213 Patient-reported outcomes (dpeaa)DE-He213 Prospective cohort (dpeaa)DE-He213 Bridwell, Keith H. aut Shaffrey, Christopher I. aut Edwards, Charles C. aut Lurie, Jon D. aut Baldus, Christine R. aut Carreon, Leah Y. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 6(2018), 1 vom: Jan., Seite 67-71 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:6 year:2018 number:1 month:01 pages:67-71 https://dx.doi.org/10.1016/j.jspd.2017.05.003 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 6 2018 1 01 67-71 |
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10.1016/j.jspd.2017.05.003 doi (DE-627)SPR038871734 (SPR)j.jspd.2017.05.003-e DE-627 ger DE-627 rakwb eng Glassman, Steven D. verfasserin aut Health-Related Quality of Life Scores Underestimate the Impact of Major Complications in Lumbar Degenerative Scoliosis Surgery 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2017 Study Design Retrospective cohort. Objective To examine Charlson Comorbidity Index (CCMI) as a marker for deterioration in health status not reflected in standard Health Related Quality of Life (HRQOL) measures. Summary of Background Data HRQOL has become a primary metric for assessing outcomes following spinal deformity surgery. However, studies have reported limited impact of complications on postoperative HRQOL outcomes. Methods We examined serial CCMI, complications, and HRQOL outcomes for 138 adult lumbar deformity patients treated surgically with a minimum two-year follow-up that included 126 females (91%) with a mean age of 59.8 years (range, 40.2–78.5). Patients with no, minor, or major complications were compared at baseline and at one and two years postoperation. Results Minor complications were observed in 26 patients (19%) and major complications in 15 (11%). Major complications included motor deficit (7), deep vein thrombosis (4), and respiratory failure (3). There was no difference in preoperative SF-36 Physical Component Summary or Scoliosis Research Society—22R (SRS-22R) scores among the groups at baseline. Preoperative CCMI was lowest in the No Complication group (3.52 ± 1.70) followed by the Major (4.00 ± 1.13) and Minor Complication groups (4.15 ± 1.71, p = .165). At one year, there was a significantly greater CCMI deterioration in the Major Complication group (0.80 ± 1.01) compared to both the Minor (0.08 ± 0.27) and No Complication groups (0.27 ± 0.47, p < .001). There was no significant difference in SF-36 Physical Component Summary or SRS-22R scores among the three groups. Similar findings were observed at two years. Conclusions Despite similar one- and two-year HRQOL improvement, patients with major complications had greater deterioration in CCMI. As CCMI is predictive of medical and surgical risk, patients who sustained a major complication now carry a greater likelihood of adverse outcomes with future interventions, including any subsequent spinal surgery. Although this increased risk may not alter the patient’s perception of his or her current health status, it may be important, and should be recognized as part of the shared decision-making process. Level of Evidence Level II, high-quality prognostic study. Lumbar scoliosis (dpeaa)DE-He213 Adult spinal deformity (dpeaa)DE-He213 Complications (dpeaa)DE-He213 Patient-reported outcomes (dpeaa)DE-He213 Prospective cohort (dpeaa)DE-He213 Bridwell, Keith H. aut Shaffrey, Christopher I. aut Edwards, Charles C. aut Lurie, Jon D. aut Baldus, Christine R. aut Carreon, Leah Y. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 6(2018), 1 vom: Jan., Seite 67-71 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:6 year:2018 number:1 month:01 pages:67-71 https://dx.doi.org/10.1016/j.jspd.2017.05.003 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 6 2018 1 01 67-71 |
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10.1016/j.jspd.2017.05.003 doi (DE-627)SPR038871734 (SPR)j.jspd.2017.05.003-e DE-627 ger DE-627 rakwb eng Glassman, Steven D. verfasserin aut Health-Related Quality of Life Scores Underestimate the Impact of Major Complications in Lumbar Degenerative Scoliosis Surgery 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2017 Study Design Retrospective cohort. Objective To examine Charlson Comorbidity Index (CCMI) as a marker for deterioration in health status not reflected in standard Health Related Quality of Life (HRQOL) measures. Summary of Background Data HRQOL has become a primary metric for assessing outcomes following spinal deformity surgery. However, studies have reported limited impact of complications on postoperative HRQOL outcomes. Methods We examined serial CCMI, complications, and HRQOL outcomes for 138 adult lumbar deformity patients treated surgically with a minimum two-year follow-up that included 126 females (91%) with a mean age of 59.8 years (range, 40.2–78.5). Patients with no, minor, or major complications were compared at baseline and at one and two years postoperation. Results Minor complications were observed in 26 patients (19%) and major complications in 15 (11%). Major complications included motor deficit (7), deep vein thrombosis (4), and respiratory failure (3). There was no difference in preoperative SF-36 Physical Component Summary or Scoliosis Research Society—22R (SRS-22R) scores among the groups at baseline. Preoperative CCMI was lowest in the No Complication group (3.52 ± 1.70) followed by the Major (4.00 ± 1.13) and Minor Complication groups (4.15 ± 1.71, p = .165). At one year, there was a significantly greater CCMI deterioration in the Major Complication group (0.80 ± 1.01) compared to both the Minor (0.08 ± 0.27) and No Complication groups (0.27 ± 0.47, p < .001). There was no significant difference in SF-36 Physical Component Summary or SRS-22R scores among the three groups. Similar findings were observed at two years. Conclusions Despite similar one- and two-year HRQOL improvement, patients with major complications had greater deterioration in CCMI. As CCMI is predictive of medical and surgical risk, patients who sustained a major complication now carry a greater likelihood of adverse outcomes with future interventions, including any subsequent spinal surgery. Although this increased risk may not alter the patient’s perception of his or her current health status, it may be important, and should be recognized as part of the shared decision-making process. Level of Evidence Level II, high-quality prognostic study. Lumbar scoliosis (dpeaa)DE-He213 Adult spinal deformity (dpeaa)DE-He213 Complications (dpeaa)DE-He213 Patient-reported outcomes (dpeaa)DE-He213 Prospective cohort (dpeaa)DE-He213 Bridwell, Keith H. aut Shaffrey, Christopher I. aut Edwards, Charles C. aut Lurie, Jon D. aut Baldus, Christine R. aut Carreon, Leah Y. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 6(2018), 1 vom: Jan., Seite 67-71 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:6 year:2018 number:1 month:01 pages:67-71 https://dx.doi.org/10.1016/j.jspd.2017.05.003 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 6 2018 1 01 67-71 |
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Objective To examine Charlson Comorbidity Index (CCMI) as a marker for deterioration in health status not reflected in standard Health Related Quality of Life (HRQOL) measures. Summary of Background Data HRQOL has become a primary metric for assessing outcomes following spinal deformity surgery. However, studies have reported limited impact of complications on postoperative HRQOL outcomes. Methods We examined serial CCMI, complications, and HRQOL outcomes for 138 adult lumbar deformity patients treated surgically with a minimum two-year follow-up that included 126 females (91%) with a mean age of 59.8 years (range, 40.2–78.5). Patients with no, minor, or major complications were compared at baseline and at one and two years postoperation. Results Minor complications were observed in 26 patients (19%) and major complications in 15 (11%). Major complications included motor deficit (7), deep vein thrombosis (4), and respiratory failure (3). There was no difference in preoperative SF-36 Physical Component Summary or Scoliosis Research Society—22R (SRS-22R) scores among the groups at baseline. Preoperative CCMI was lowest in the No Complication group (3.52 ± 1.70) followed by the Major (4.00 ± 1.13) and Minor Complication groups (4.15 ± 1.71, p = .165). At one year, there was a significantly greater CCMI deterioration in the Major Complication group (0.80 ± 1.01) compared to both the Minor (0.08 ± 0.27) and No Complication groups (0.27 ± 0.47, p < .001). There was no significant difference in SF-36 Physical Component Summary or SRS-22R scores among the three groups. Similar findings were observed at two years. Conclusions Despite similar one- and two-year HRQOL improvement, patients with major complications had greater deterioration in CCMI. As CCMI is predictive of medical and surgical risk, patients who sustained a major complication now carry a greater likelihood of adverse outcomes with future interventions, including any subsequent spinal surgery. Although this increased risk may not alter the patient’s perception of his or her current health status, it may be important, and should be recognized as part of the shared decision-making process. 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Glassman, Steven D. misc Lumbar scoliosis misc Adult spinal deformity misc Complications misc Patient-reported outcomes misc Prospective cohort Health-Related Quality of Life Scores Underestimate the Impact of Major Complications in Lumbar Degenerative Scoliosis Surgery |
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Health-Related Quality of Life Scores Underestimate the Impact of Major Complications in Lumbar Degenerative Scoliosis Surgery Lumbar scoliosis (dpeaa)DE-He213 Adult spinal deformity (dpeaa)DE-He213 Complications (dpeaa)DE-He213 Patient-reported outcomes (dpeaa)DE-He213 Prospective cohort (dpeaa)DE-He213 |
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Glassman, Steven D. Bridwell, Keith H. Shaffrey, Christopher I. Edwards, Charles C. Lurie, Jon D. Baldus, Christine R. Carreon, Leah Y. |
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health-related quality of life scores underestimate the impact of major complications in lumbar degenerative scoliosis surgery |
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Health-Related Quality of Life Scores Underestimate the Impact of Major Complications in Lumbar Degenerative Scoliosis Surgery |
| abstract |
Study Design Retrospective cohort. Objective To examine Charlson Comorbidity Index (CCMI) as a marker for deterioration in health status not reflected in standard Health Related Quality of Life (HRQOL) measures. Summary of Background Data HRQOL has become a primary metric for assessing outcomes following spinal deformity surgery. However, studies have reported limited impact of complications on postoperative HRQOL outcomes. Methods We examined serial CCMI, complications, and HRQOL outcomes for 138 adult lumbar deformity patients treated surgically with a minimum two-year follow-up that included 126 females (91%) with a mean age of 59.8 years (range, 40.2–78.5). Patients with no, minor, or major complications were compared at baseline and at one and two years postoperation. Results Minor complications were observed in 26 patients (19%) and major complications in 15 (11%). Major complications included motor deficit (7), deep vein thrombosis (4), and respiratory failure (3). There was no difference in preoperative SF-36 Physical Component Summary or Scoliosis Research Society—22R (SRS-22R) scores among the groups at baseline. Preoperative CCMI was lowest in the No Complication group (3.52 ± 1.70) followed by the Major (4.00 ± 1.13) and Minor Complication groups (4.15 ± 1.71, p = .165). At one year, there was a significantly greater CCMI deterioration in the Major Complication group (0.80 ± 1.01) compared to both the Minor (0.08 ± 0.27) and No Complication groups (0.27 ± 0.47, p < .001). There was no significant difference in SF-36 Physical Component Summary or SRS-22R scores among the three groups. Similar findings were observed at two years. Conclusions Despite similar one- and two-year HRQOL improvement, patients with major complications had greater deterioration in CCMI. As CCMI is predictive of medical and surgical risk, patients who sustained a major complication now carry a greater likelihood of adverse outcomes with future interventions, including any subsequent spinal surgery. Although this increased risk may not alter the patient’s perception of his or her current health status, it may be important, and should be recognized as part of the shared decision-making process. Level of Evidence Level II, high-quality prognostic study. © Scoliosis Research Society 2017 |
| abstractGer |
Study Design Retrospective cohort. Objective To examine Charlson Comorbidity Index (CCMI) as a marker for deterioration in health status not reflected in standard Health Related Quality of Life (HRQOL) measures. Summary of Background Data HRQOL has become a primary metric for assessing outcomes following spinal deformity surgery. However, studies have reported limited impact of complications on postoperative HRQOL outcomes. Methods We examined serial CCMI, complications, and HRQOL outcomes for 138 adult lumbar deformity patients treated surgically with a minimum two-year follow-up that included 126 females (91%) with a mean age of 59.8 years (range, 40.2–78.5). Patients with no, minor, or major complications were compared at baseline and at one and two years postoperation. Results Minor complications were observed in 26 patients (19%) and major complications in 15 (11%). Major complications included motor deficit (7), deep vein thrombosis (4), and respiratory failure (3). There was no difference in preoperative SF-36 Physical Component Summary or Scoliosis Research Society—22R (SRS-22R) scores among the groups at baseline. Preoperative CCMI was lowest in the No Complication group (3.52 ± 1.70) followed by the Major (4.00 ± 1.13) and Minor Complication groups (4.15 ± 1.71, p = .165). At one year, there was a significantly greater CCMI deterioration in the Major Complication group (0.80 ± 1.01) compared to both the Minor (0.08 ± 0.27) and No Complication groups (0.27 ± 0.47, p < .001). There was no significant difference in SF-36 Physical Component Summary or SRS-22R scores among the three groups. Similar findings were observed at two years. Conclusions Despite similar one- and two-year HRQOL improvement, patients with major complications had greater deterioration in CCMI. As CCMI is predictive of medical and surgical risk, patients who sustained a major complication now carry a greater likelihood of adverse outcomes with future interventions, including any subsequent spinal surgery. Although this increased risk may not alter the patient’s perception of his or her current health status, it may be important, and should be recognized as part of the shared decision-making process. Level of Evidence Level II, high-quality prognostic study. © Scoliosis Research Society 2017 |
| abstract_unstemmed |
Study Design Retrospective cohort. Objective To examine Charlson Comorbidity Index (CCMI) as a marker for deterioration in health status not reflected in standard Health Related Quality of Life (HRQOL) measures. Summary of Background Data HRQOL has become a primary metric for assessing outcomes following spinal deformity surgery. However, studies have reported limited impact of complications on postoperative HRQOL outcomes. Methods We examined serial CCMI, complications, and HRQOL outcomes for 138 adult lumbar deformity patients treated surgically with a minimum two-year follow-up that included 126 females (91%) with a mean age of 59.8 years (range, 40.2–78.5). Patients with no, minor, or major complications were compared at baseline and at one and two years postoperation. Results Minor complications were observed in 26 patients (19%) and major complications in 15 (11%). Major complications included motor deficit (7), deep vein thrombosis (4), and respiratory failure (3). There was no difference in preoperative SF-36 Physical Component Summary or Scoliosis Research Society—22R (SRS-22R) scores among the groups at baseline. Preoperative CCMI was lowest in the No Complication group (3.52 ± 1.70) followed by the Major (4.00 ± 1.13) and Minor Complication groups (4.15 ± 1.71, p = .165). At one year, there was a significantly greater CCMI deterioration in the Major Complication group (0.80 ± 1.01) compared to both the Minor (0.08 ± 0.27) and No Complication groups (0.27 ± 0.47, p < .001). There was no significant difference in SF-36 Physical Component Summary or SRS-22R scores among the three groups. Similar findings were observed at two years. Conclusions Despite similar one- and two-year HRQOL improvement, patients with major complications had greater deterioration in CCMI. As CCMI is predictive of medical and surgical risk, patients who sustained a major complication now carry a greater likelihood of adverse outcomes with future interventions, including any subsequent spinal surgery. Although this increased risk may not alter the patient’s perception of his or her current health status, it may be important, and should be recognized as part of the shared decision-making process. Level of Evidence Level II, high-quality prognostic study. © Scoliosis Research Society 2017 |
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