The impact of preoperative depression on quality of life outcomes after lumbar surgery

Miller, Jacob A.; Derakhshan, Adeeb; Lubelski, Daniel; Alvin, Matthew D.; McGirt, Matthew J.; Benzel, Edward C.; Mroz, Thomas E.

doi:10.1016/j.spinee.2014.06.020

Cited by 82 publications

(56 citation statements)

References 24 publications

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“…This will include age, gender, current smoking status [14, 15], obesity [14, 18], diabetes [14, 16, 17], depression [19, 20], duration of pain/symptoms [35], neurological deficit [14], anxiety, pre-operative activity, pre-operative mobility, surgical procedure, multi-level surgery, and pre-operative function.…”

Section: Methodsmentioning

confidence: 99%

“…These include patient demographics (age [13], smoking status [14–16]), co-morbidities (diabetes [14, 16, 17], obesity [14, 18]), impairments (pain and sensory changes [14]), and psycho-social factors (depression [19, 20], fear avoidance [21]). These factors play an important role in selecting patients appropriate for surgical intervention.…”

Section: Introductionmentioning

confidence: 99%

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Does walking after lumbar spinal surgery predict recovery of function at six months? Protocol for a prospective cohort study

Gilmore

McClelland

Davidson

2016

BMC Musculoskelet Disord

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BackgroundPhysiotherapists are commonly involved in the management of patients immediately following lumbar spinal surgery. There is however, very little research to guide physiotherapy intervention in the acute post-operative period, and the advice provided to patients regarding post-operative walking and physical activity has been shown to be highly variable.The primary aim of this research is to establish whether the amount of walking patients perform in the week following lumbar spinal surgery predicts improvement in function at 6 months.MethodsThis study will be a prospective cohort study design, with a projected sample size of 250 participants. Patients undergoing surgery for the management of a disc prolapse, degenerative disc disease, lumbar spinal stenosis and/or degenerative spondylolysthesis will be invited to participate in this study.Outcome measurement will take place pre-operatively and at six months post-operatively. The primary outcome variable will be self-reported function, measured using the Modified Oswestry Disability Questionnaire and the physical component summary of the SF-36.Each participant will be fitted with an activPAL3 accelerometer to be worn for the first seven post-operative days. This accelerometer will record time spent in active versus sedentary postures, step count and time spent walking. Multivariable logistic regression analysis will be used to investigate the relationship between the total time spent walking over the first seven post-operative days, and outcome at six months.DiscussionThe results from this research will help to guide patient management during the inpatient phase, by identifying patients who are at risk of poorer outcome due to limited walking time. These patients may benefit from ongoing rehabilitation and outpatient physiotherapy services. This information will also provide a foundation for further research into interventions designed to optimise post-operative activity.Trial registration ACTRN12616000747426, retrospectively registered 7th June 2016.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does walking after lumbar spinal surgery predict recovery of function at six months? Protocol for a prospective cohort study

Gilmore

McClelland

Davidson

2016

BMC Musculoskelet Disord

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“…5 Extent of preoperative depression has been shown to influence postoperative patient satisfaction and patient-reported quality of life. 1,17 The ODI and NDI provide patient-reported information on disability. The ODI is a tool for measuring disability in patients with back pain and has long been validated in determining patient outcome following spine surgery.…”

Section: Choice Of Qol Measuresmentioning

confidence: 99%

Building an electronic health record integrated quality of life outcomes registry for spine surgery

Azad

Kalani

Wolf

et al. 2016

SPI

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OBJECT Demonstrating the value of spine care requires adequate outcomes assessment. Long-term outcomes are best measured as overall improvement in quality of life (QOL) after surgical intervention. Present registries often require parallel data entry, introducing inefficiencies and limiting compliance. The authors detail the methodology of constructing an integrated electronic health record (EHR) system to collect QOL metrics and demonstrate the effect of data collection on routine clinical workflow. A streamlined approach to collecting QOL data can capture patient data without requiring dual data entry and without increasing clinic visit times. METHODS Through extensive literature review, a combination of QOL assessments was selected, consisting of the Patient Health Questionnaire-2 and -9, Oswestry Disability Index, Neck Disability Index, and visual analog scale for pain. These metrics were used to provide assessment of QOL following spine surgery and were incorporated into standard clinic workflow by a multidisciplinary team of surgeons, advanced practice providers, and health care information technology specialists. A clinical dashboard tracking more than 25 patient variables was developed. Clinic flow was assessed and opportunities for improvement reviewed. Duration of clinic visits before and after initiation of QOL measure capture was recorded, with assessment of mean clinic visit times for the 12 months before and the 12 months after implementation. RESULTS The integrated QOL capture was instituted for 3 spine surgeons in a tertiary care academic center. In the 12-month period prior to initiating collection of QOL data, 806 new patient visits were completed with an average visit time of 127.9 ± 51.5 minutes. In the 12 months after implementation, 1013 new patient visits were recorded, with 791 providing QOL measures with an average visit time of 117.0 ± 45.7 minutes. Initially the primary means of collecting patient outcome data was via paper form, with gradual transition to collection via entry into the electronic medical records system. To improve electronic data capture, paper forms were eliminated and an online portal used as part of the patient rooming process. This improved electronic capture to nearly 98% without decreasing the number of patients enrolled in the process. CONCLUSIONS A systematic approach to collecting spine-related QOL data within an EHR system is feasible and offers distinct advantages over registries that require dual data entry. The process of data collection does not impact patients’ clinical visit or providers’ clinical workflow. This approach is scalable, and may form the foundation for a decentralized outcomes registry network.

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“…There is evidence that depression and anxiety predict outcomes, including return to work, 105 medical complications, 78 functional recovery, 29,133 and quality of life. 90 Screening may aid in appropriate patient selection. In one large prospective study, depressive symptoms predicted functional improvement after nonsurgical treatment of chronic low-back pain.…”

Section: Rationalementioning

confidence: 99%

The National Neurosurgery Quality and Outcomes Database Qualified Clinical Data Registry: 2015 measure specifications and rationale

Parker¹,

McGirt

Bekelis

et al. 2015

FOC

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Meaningful quality measurement and public reporting have the potential to facilitate targeted outcome improvement, practice-based learning, shared decision making, and effective resource utilization. Recent developments in national quality reporting programs, such as the Centers for Medicare & Medicaid Services Qualified Clinical Data Registry (QCDR) reporting option, have enhanced the ability of specialty groups to develop relevant quality measures of the care they deliver. QCDRs will complete the collection and submission of Physician Quality Reporting System (PQRS) quality measures data on behalf of individual eligible professionals. The National Neurosurgery Quality and Outcomes Database (N2QOD) offers 21 non-PQRS measures, initially focused on spine procedures, which are the first specialty-specific measures for neurosurgery. Securing QCDR status for N2QOD is a tremendously important accomplishment for our specialty. This program will ensure that data collected through our registries and used for PQRS is meaningful for neurosurgeons, related spine care practitioners, their patients, and other stakeholders. The 2015 N2QOD QCDR is further evidence of neurosurgery’s commitment to substantively advancing the health care quality paradigm. The following manuscript outlines the measures now approved for use in the 2015 N2QOD QCDR. Measure specifications (measure type and descriptions, related measures, if any, as well as relevant National Quality Strategy domain[s]) along with rationale are provided for each measure.

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The impact of preoperative depression on quality of life outcomes after lumbar surgery

Cited by 82 publications

References 24 publications

Does walking after lumbar spinal surgery predict recovery of function at six months? Protocol for a prospective cohort study

Does walking after lumbar spinal surgery predict recovery of function at six months? Protocol for a prospective cohort study

Building an electronic health record integrated quality of life outcomes registry for spine surgery

The National Neurosurgery Quality and Outcomes Database Qualified Clinical Data Registry: 2015 measure specifications and rationale

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