Patient satisfaction is good indicator of success after spinal surgery
Patient satisfaction ratings after surgery for spinal degenerative disease – especially in terms of reduced pain and disability – are a good indicator of the procedure’s effectiveness, according to a new study published in Neurosurgery.
Clinton Devin and co-workers at Vanderbilt University Medical Center in Nashville, USA, analysed one-year follow-up data on 1,645 patients undergoing surgery for degenerative disease of the cervical and lumbar spine. Before, and one year after surgery, the patients were evaluated using standard rating scales for disability and neck, back, arm and leg pain.
Based on a spinal surgery satisfaction scale, 83 per cent of patients said they were satisfied with the outcomes of surgery one year later. The researchers wanted to see whether any of the factors evaluated before surgery could predict whether patients would be satisfied or dissatisfied with their outcomes.
After adjustment for a wide array of patient-specific factors, several specific predictors were identified. Patients who didn’t have at least a 15 per cent improvement on a standard disability rating scale – considered to be the “minimal clinically important difference” – were four times more likely to be dissatisfied with their surgical outcomes.
Patients who didn’t achieve minimal clinically important differences in pain scores were about three times more likely to be dissatisfied with the results of surgery. Patients with depression or anxiety before surgery were less likely to achieve clinically meaningful improvement, and had lower satisfaction rates; however, after adjustment for initial pain and disability scores, these mental health factors were less significant.
“Patient satisfaction with outcome may accurately represent the effectiveness of surgical spine care in terms of one-year improvement in pain and disability,” said Devin, adding that further research was needed to clarify the impact of insurance status and initial severity scores on the outcomes of surgery for degenerative spine disease.
Patient satisfaction scores are increasingly used as measures of the quality of medical care – and as a determinant of reimbursement for care provided.
Source: Wolters Kluwer Health
Chotai, S., Sivaganesan, A., Parker, S., et al. (2015) Patient-specific factors associated with dissatisfaction after elective surgery for degenerative spine diseases. Neurosurgery 77(2), 157–163. doi: 10.1227/NEU.000000000000076