Does the number of social factors affect long-term patient-reported outcomes and satisfaction in those with cervical myelopathy? A QOD study.

dc.contributor.author

Park, Christine

dc.contributor.author

Shaffrey, Christopher I

dc.contributor.author

Than, Khoi D

dc.contributor.author

Bisson, Erica F

dc.contributor.author

Sherrod, Brandon A

dc.contributor.author

Asher, Anthony L

dc.contributor.author

Coric, Domagoj

dc.contributor.author

Potts, Eric A

dc.contributor.author

Foley, Kevin T

dc.contributor.author

Wang, Michael Y

dc.contributor.author

Fu, Kai-Ming

dc.contributor.author

Virk, Michael S

dc.contributor.author

Knightly, John J

dc.contributor.author

Meyer, Scott

dc.contributor.author

Park, Paul

dc.contributor.author

Upadhyaya, Cheerag

dc.contributor.author

Shaffrey, Mark E

dc.contributor.author

Buchholz, Avery L

dc.contributor.author

Tumialán, Luis M

dc.contributor.author

Turner, Jay D

dc.contributor.author

Agarwal, Nitin

dc.contributor.author

Chan, Andrew K

dc.contributor.author

Chou, Dean

dc.contributor.author

Chaudhry, Nauman S

dc.contributor.author

Haid, Regis W

dc.contributor.author

Mummaneni, Praveen V

dc.contributor.author

Michalopoulos, Georgios D

dc.contributor.author

Bydon, Mohamad

dc.contributor.author

Gottfried, Oren N

dc.date.accessioned

2024-01-31T14:17:48Z

dc.date.available

2024-01-31T14:17:48Z

dc.date.issued

2024-01

dc.description.abstract

It is not clear whether there is an additive effect of social factors in keeping patients with cervical spondylotic myelopathy (CSM) from achieving both a minimum clinically important difference (MCID) in outcomes and satisfaction after surgery. The aim of this study was to explore the effect of multiple social factors on postoperative outcomes and satisfaction. This was a multiinstitutional, retrospective study of the prospective Quality Outcomes Database (QOD) CSM cohort, which included patients aged 18 years or older who were diagnosed with primary CSM and underwent operative management. Social factors included race (White vs non-White), education (high school or below vs above), employment (employed vs not), and insurance (private vs nonprivate). Patients were considered to have improved from surgery if the following criteria were met: 1) they reported a score of 1 or 2 on the North American Spine Society index, and 2) they met the MCID in patient-reported outcomes (i.e., visual analog scale [VAS] neck and arm pain, Neck Disability Index [NDI], and EuroQol-5D [EQ-5D]). Of the 1141 patients included in the study, 205 (18.0%) had 0, 347 (30.4%) had 1, 334 (29.3%) had 2, and 255 (22.3%) had 3 social factors. The 24-month follow-up rate was > 80% for all patient-reported outcomes. After adjusting for all relevant covariates (p < 0.02), patients with 1 or more social factors were less likely to improve from surgery in all measured outcomes including VAS neck pain (OR 0.90, 95% CI 0.83-0.99) and arm pain (OR 0.88, 95% CI 0.80-0.96); NDI (OR 0.90, 95% CI 0.83-0.98); and EQ-5D (OR 0.90, 95% CI 0.83-0.97) (all p < 0.05) compared to those without any social factors. Patients with 2 social factors (outcomes: neck pain OR 0.86, arm pain OR 0.81, NDI OR 0.84, EQ-5D OR 0.81; all p < 0.05) or 3 social factors (outcomes: neck pain OR 0.84, arm pain OR 0.84, NDI OR 0.84, EQ-5D OR 0.84; all p < 0.05) were more likely to fare worse in all outcomes compared to those with only 1 social factor. Compared to those without any social factors, patients who had at least 1 social factor were less likely to achieve MCID and feel satisfied after surgery. The effect of social factors is additive in that patients with a higher number of factors are less likely to improve compared to those with only 1 social factor.

dc.identifier.issn

1547-5654

dc.identifier.issn

1547-5646

dc.identifier.uri

https://hdl.handle.net/10161/29920

dc.language

eng

dc.publisher

Journal of Neurosurgery Publishing Group (JNSPG)

dc.relation.ispartof

Journal of neurosurgery. Spine

dc.relation.isversionof

10.3171/2023.11.spine23127

dc.rights.uri

https://creativecommons.org/licenses/by-nc/4.0

dc.subject

Quality Outcomes Database

dc.subject

cervical spondylotic myelopathy

dc.subject

pain

dc.subject

patient-reported outcomes

dc.subject

satisfaction

dc.subject

social factors

dc.title

Does the number of social factors affect long-term patient-reported outcomes and satisfaction in those with cervical myelopathy? A QOD study.

dc.type

Journal article

duke.contributor.orcid

Shaffrey, Christopher I|0000-0001-9760-8386

pubs.begin-page

1

pubs.end-page

11

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Orthopaedic Surgery

pubs.organisational-group

Neurosurgery

pubs.publication-status

Published

Files

Original bundle

Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
j-neurosurg-spine-article-10.3171-2023.11.SPINE23127.pdf
Size:
1.7 MB
Format:
Adobe Portable Document Format