Yonsei Med J.  2016 Sep;57(5):1214-1221. 10.3349/ymj.2016.57.5.1214.

Surgical Outcome Predictor in Degenerative Lumbar Spinal Disease Based on Health Related Quality of Life Using Euro-Quality 5 Dimensions Analysis

• Lee BH
• Yang JH
• Lee HM
• Park JY
• Park SE
• Moon SH

• KMID: 2374168
• DOI: http://doi.org/10.3349/ymj.2016.57.5.1214

Abstract

PURPOSE
We aim to introduce the predictive value of a quantitatively described formula model in a multicenter prospective analysis using the EuroQol-5 dimensions (EQ-5D) health scale to anticipate postoperative improvement in patients with degenerative lumbar spine disease (DLSD).
MATERIALS AND METHODS
Quality of life was evaluated in 376 patients from 17 tertiary hospitals before and after spinal decompression and fusion surgery. The five items of the EQ-5D, mobility (M), self-care (S), usual activities (A), pain/discomfort (P), and anxiety/depression (D), were checked as level 1, 2, or 3, with 3 being the worst. A minimal significant change in the calculated EQ-5D (cEQ-5D) was set as 0.05. Logistic regression analysis was performed to predict the highest successful outcome (cEQ-5D improvement after operation >0.05) with the given sets of 5 items of the EQ-5D.
RESULTS
In the cEQ-5D analysis, among patients with a formula score of S+A+2×P+D≤8, 18/68 (27%) showed significant improvement in the cEQ-5D at 1 year postoperatively (p<0.05). However, in patients with a formula score of ≥9, 265/308 (86%) demonstrated significant improvements in the cEQ-5D at 1 year postoperatively (p<0.05).
CONCLUSION
We suggest that S+A+2×P+D≥9 in the EQ-5D can quantitatively describe the better surgical outcome predictors for DLSD. With a definite DLSD lesion confirmed by an imaging study, patients who meet the formula scores of 9 or over and have refractory symptoms to non-operative treatment could be better surgical candidates resulting in satisfactory surgical outcomes of over 86%, than those who scored 8 or lower.

Keyword

Lumbar vertebrae; outcome assessment; surgical procedure; degenerative; spinal disease

MeSH Terms

Aged
Aged, 80 and over
Decompression, Surgical/adverse effects
Female
*Health
Humans
Lumbar Vertebrae/*surgery
Male
Middle Aged
Postoperative Complications/etiology/psychology
Postoperative Period
Prognosis
Prospective Studies
*Quality of Life
Self Care
Spinal Diseases/diagnosis/*surgery
Surveys and Questionnaires
Treatment Outcome

Figure

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  Fig. 1 Enrollment and follow-up of the study participants.

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