Factors influencing patient satisfaction after adult scoliosis and spinal deformity surgery
Factors influencing patient satisfaction after adult scoliosis and spinal deformity surgery
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DOI：
10.3171/2019.2.spine181486
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发表时间：
2019-09-01
影响因子：
2.8
通讯作者：
Obeid, Ibrahim
中科院分区：
文献类型：
--
作者：
Hayashi, Kazunori;Boissiere, Louis;Obeid, Ibrahim
目的成人脊柱畸形(ASD)术后患者对治疗的满意度往往是其追求的目标之一。然而，有关相关因素及其与患者满意度的相关性的文献有限。本研究的目的是从术后2年的管理角度确定与患者满意度独立相关的临床和放射学因素。检查患者的人口学特征、并发症、健康相关生活质量(HRQOL)亚域和放射学参数，以确定其与脊柱侧凸研究会-22问卷(SRS-22R)2年满意度评分(Sat-2y评分)的相关系数。随后，两年时被确定为与低满意度(Sat-2y分数=2分；OR 4.48)和疼痛强度(>；=2分；OR 2.07)、SRS-22R SI/外观亚域(<；3分；OR 2.70)以及2年时较大的矢状轴(>；5 cm；OR 2.68)独立相关的因素是低满意度的独立相关因素。根据另一种模型，站立(30%；OR 2.68)、SRS-22R疼痛(<；50%；OR 3.25)和SI/外观(<；50%；OR 2.18)亚域的ODI改善较低，以及SVA从基线(<；2 cm；OR 3.16)恢复不充分与低满意度相关。结论在ASD术后2年，自我形象、疼痛、站立困难和矢状位恢复可能是提高患者对治疗满意度的有用目标。外科医生和其他医疗提供者必须注意这些因素，以防止满意度低下。
OBJECTIVE Achieving high patient satisfaction with management is often one of the goals after adult spinal deformity (ASD) surgery. However, literature on associated factors and their correlations with patient satisfaction is limited. The aim of this study was to determine the clinical and radiographic factors independently correlated with patient satisfaction in terms of management at 2 years after surgery.METHODS A multicenter prospective database of ASD surgery was retrospectively reviewed. The demographics, complications, health-related quality of life (HRQOL) subdomains, and radiographic parameters were examined to determine their correlation coefficients with the Scoliosis Research Society-22 questionnaire (SRS-22R) satisfaction scores at 2 years (Sat-2y score). Subsequently, factors determined to be independently associated with low satisfaction (Sat-2y score = 2 points; OR 4.48) and pain intensity (>= 2 points; OR 2.07), SRS-22R SI/appearance subdomain (< 3 points; OR 2.70) at 2 years, and a greater sagittal vertical axis (SVA) (> 5 cm; OR 2.68) at 2 years were independent related factors for low satisfaction. According to the other model, a lower improvement in ODI for standing (< 30%; OR 2.68), SRS-22R pain (< 50%; OR 3.25) and SI/appearance (< 50%; OR 2.18) subdomains, and an inadequate restoration of the SVA from baseline (< 2 cm; OR 3.16) were associated with low satisfaction.CONCLUSIONS Self-image, pain, standing difficulty, and sagittal alignment restoration may be useful goals in improving patient satisfaction with management at 2 years after ASD surgery. Surgeons and other medical providers have to take care of these factors to prevent low satisfaction.