The Norwegian registry for spine surgery (NORspine): cohort profile

Abstract

Purpose To review and describe the development, methods and cohort of the lumbosacral part of the Norwegian registry for spine surgery (NORspine). Methods NORspine was established in 2007. It is government funded, covers all providers and captures consecutive cases undergoing operations for degenerative disorders. Patients’ participation is voluntary and requires informed consent. A set of baseline-, process- and outcome-variables (3 and 12 months) recommended by the International Consortium for Health Outcome Measurement is reported by surgeons and patients. The main outcome is the Oswestry disability index (ODI) at 12 months. Results We show satisfactory data quality assessed by completeness, timeliness, accuracy, relevance and comparability. The coverage rate has been 100% since 2016 and the capture rate has increased to 74% in 2021. The cohort consists of 60,647 (47.6% women) cases with mean age 55.7 years, registered during the years 2007 through 2021. The proportions > 70 years and with an American Society of Anaesthesiologists’ Physical Classification System (ASA) score > II has increased gradually to 26.1% and 19.3%, respectively. Mean ODI at baseline was 43.0 (standard deviation 17.3). Most cases were operated with decompression for disc herniation (n = 26,557, 43.8%) or spinal stenosis (n = 26,545, 43.8%), and 7417 (12.2%) with additional or primary fusion. The response rate at 12 months follow-up was 71.6%. Conclusion NORspine is a well-designed population-based comprehensive national clinical quality registry. The register’s methods ensure appropriate data for quality surveillance and improvement, and research.

Postoperative complications after surgery for lumbar spinal stenosis, assessment using two different data sources

“…We included patients treated for LSS at four selected hospitals during 2015 and 2016 who consented and reported on outcomes, satisfaction, and complications to the NORspine registry. NORspine is a mandatory national registry for degenerative spine surgery, covering all spine treatment centres in Norway [ 17 ]. Ideally, all patients receiving spine surgery in Norway are included in the registry; however, the capture rate is about 74% [ 17 ].…”

“…NORspine is a mandatory national registry for degenerative spine surgery, covering all spine treatment centres in Norway [ 17 ]. Ideally, all patients receiving spine surgery in Norway are included in the registry; however, the capture rate is about 74% [ 17 ]. The exclusion criteria in the NORspine registry are patients unable to give informed consent, aged under 18 years, patients with severe psychiatric diagnoses or drug problems, as well as patients treated for spinal tumours, fractures, or infections.…”

“…The registry also includes surgeon-reported variables regarding diagnosis and surgical details (including perioperative complications and reoperations within 90 days), radiologic findings, and relevant comorbidities. Clinical outcome is recorded by the patients after three — and twelve months using common PROMS, a transitional scale (Global Perceived Effect (GPE) and patient satisfaction [ 17 ]. The Global Perceived Effect (GPE) is a seven-step scale on clinical change (“worse than ever”, “much worse”, “somewhat worse”, “unchanged”, “somewhat better”, “much improved”, and “ completely recovered”) [ 12 ].…”

“…In NORspine, postoperative complications are recorded by the patients themselves at three months follow-up, and the follow-up rate in NORspine is 72% [ 17 ].…”

Machine Learning Models for Predicting Disability and Pain Following Lumbar Disc Herniation Surgery

“…The NORspine registry data quality is periodically assessed by the registry owner to detect systematic or random errors in the data entry. 30 We performed further data quality checks during data cleaning, including assessment of potential duplicate entries, outliers, the extent of missing data, and presence of systematically missing variables within and across clusters. All patient characteristics and model predictors were determined at the time of surgical admission.…”