scholarly journals The Association Between Chronicity of Preoperative Opioid Usage Between Patient Satisfaction, Return to Work, and Achieving ODI MCID up to 2 Years After Lumbar Fusion: Analysis From the Michigan Spine Surgery Improvement Collaborative (MSSIC)

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Hesham M Zakaria ◽  
Tarek R Mansour ◽  
Edvin Telemi ◽  
Karam P Asmaro ◽  
Theresa A Elder ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Return To Work ◽  
Spine Surgery ◽  
Lumbar Fusion ◽  
Favorable Outcome ◽  
Satisfaction Index ◽  
Fusion Analysis ◽  
Opioid Users ◽  
The Relationship ◽  
Prospective Database

Abstract INTRODUCTION The Michigan Spine Surgery Improvement Collaborative (MSSIC) is a multicenter quality improvement collaborative. Using the MSSIC database, we sought to identify the relationship between preoperative opioid usage and patient satisfaction, return to work, and achieving ODI MCID up to 2-yr after lumbar fusion. METHODS A total of 8693 lumbar fusion patients were analyzed. Patient satisfaction was measured by the NASS patient satisfaction index. Generalized estimating equations (GEE) models were constructed; variables tested include age, gender, race, PMH, and number of surgical levels. Preoperative opioid chronicity was defined as opioid naïve (no opioid usage), new opioid users (<6 wk), recent opioid users (6 wk-3 mo), frequent opioid users (3 mo-6 mo), and chronic opioid users (>6 mo). Comparisons were made to opioid naïve patients. RESULTS Chronic opioid users were less likely to be satisfied with their procedure at 90-d (OR 0.95, P < .001), 1-yr (OR 0.90, P < .001), and 2-yr (OR 0.87, P < .001) after surgery. New opioid users were more likely to achieve ODI MCID at 90-d (OR 1.25, P < .001), 1-yr (OR 1.15, P < .001), and 2-yr (OR 1.22, P < .002) postoperatively. Recent opioid users were more likely to achieve ODI MCID at 2 yr (OR 1.26, P < .001). Chronic opioid users were less likely to achieve ODI MCID at 90-d (OR 0.89, P < .001), 1-yr (OR 0.87, P = .002), and 2-yr (OR 0.82, P = .004). Chronic opioid users were also less likely to return to work at 90-d (OR 0.83, P < .001). CONCLUSION A multivariate analysis on preoperative opioid usage from a large, multicenter, prospective database on lumbar fusion patients was performed. We found that, as compared to opioid naïve patients, 2-yr postoperatively new opioid users (<6 wk) were more likely to have a favorable outcome, while chronic opioid users (>6 mo) were less likely to have a favorable outcome. Thus, preoperative opioid counseling is imperative to improve outcomes in spine surgery.

scholarly journals The Association Between PHQ-2 Screening and Patient Satisfaction and Return to Work Up To 2-Years After Lumbar Fusion: Analysis From the Michigan Spine Surgery Improvement Collaborative (MSSIC)

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Hesham M Zakaria ◽  
Tarek R Mansour ◽  
Edvin Telemi ◽  
Rachel J Hunt ◽  
Karam P Asmaro ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Return To Work ◽  
Spine Surgery ◽  
Lumbar Fusion ◽  
Radicular Pain ◽  
Satisfaction Index ◽  
Returning To Work ◽  
Axial Pain ◽  
Fusion Analysis ◽  
Prospective Longitudinal

Abstract INTRODUCTION The Michigan Spine Surgery Improvement Collaborative (MSSIC) is a prospective, longitudinal, multicenter, quality improvement collaborative. Using MSSIC, we sought to identify the relationship between a positive PHQ-2, which is predictive of depression, and patient satisfaction, return to work, and achieving ODI MCID up to 2-yr after lumbar fusion. METHODS A total of 8585 lumbar fusion patients were analyzed. Patient satisfaction was measured by the NASS patient satisfaction index. A positive PHQ-2 score is =3, which has a 82.9% sensitivity and 90.0% specificity in detecting major depressive disorder. Generalized estimating equations (GEE) models were constructed; variables tested include age, gender, race, PMH, preoperative diagnosis (disc herniation, spondylolisthesis, etc), preoperative symptoms (axial pain, radicular pain, etc), severity of surgery, and preoperative opioid usage. RESULTS Patients with a positive PHQ-2 score were less likely to be satisfied after lumbar fusion at 90-d (OR 0.93, P < .001), 1-yr (OR 0.92, P = .001), and 2-yr (OR 0.92, P = .028). A positive PHQ-2 was also associated with decreased likelihood of returning to work at 90-d (OR 0.76, P < .001), 1-yr (OR 0.85, P = .001), and at 2-yr (OR 0.82, P = .031). A positive PHQ-2 was predictive of failure to achieve ODI MCID at 90-d (OR 1.07, P = .005) but not at 1-yr or 2-yr after lumbar fusion. CONCLUSION A multivariate analysis from a large, multicenter, prospective database on lumbar fusion patients was performed. We find that PHQ-2, which is a simple and accurate screening tool for depression, is associated with an inability to return to work and worse satisfaction up to 2-yr after lumbar fusion. Depression is a treatable condition, and so in the same way that patients are medically optimized before surgery to decrease postoperative morbidity, then perhaps patients should have preoperative psychiatric optimization to improve postoperative functional outcomes.

Use of Patient Health Questionnaire–2 scoring to predict patient satisfaction and return to work up to 1 year after lumbar fusion: a 2-year analysis from the Michigan Spine Surgery Improvement Collaborative

2019 ◽  
Vol 31 (6) ◽  
pp. 794-801 ◽  
Author(s):  
Hesham Mostafa Zakaria ◽  
Tarek R. Mansour ◽  
Edvin Telemi ◽  
Karam Asmaro ◽  
Mohamed Macki ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Patient Satisfaction ◽  
Return To Work ◽  
Spine Surgery ◽  
Lumbar Fusion ◽  
Estimating Equation ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Patient Health ◽  
Prospective Longitudinal

OBJECTIVEThe Michigan Spine Surgery Improvement Collaborative (MSSIC) is a prospective, longitudinal, multicenter, quality-improvement collaborative. Using MSSIC, the authors sought to identify the relationship between a positive Patient Health Questionnaire–2 (PHQ-2) screening, which is predictive of depression, and patient satisfaction, return to work, and achieving Oswestry Disability Index (ODI) minimal clinically important difference (MCID) scores up to 2 years after lumbar fusion.METHODSData from a total of 8585 lumbar fusion patients were analyzed. Patient satisfaction was measured by the North American Spine Society patient satisfaction index. A positive PHQ-2 score is one that is ≥ 3, which has an 82.9% sensitivity and 90.0% specificity in detecting major depressive disorder. Generalized estimating equation models were constructed; variables tested include age, sex, race, past medical history, severity of surgery, and preoperative opioid usage.RESULTSMultivariate analysis was performed. Patients with a positive PHQ-2 score (i.e., ≥ 3) were less likely to be satisfied after lumbar fusion at 90 days (relative risk [RR] 0.93, p < 0.001), 1 year (RR 0.92, p = 0.001), and 2 years (RR 0.92, p = 0.028). A positive PHQ-2 score was also associated with decreased likelihood of returning to work at 90 days (RR 0.76, p < 0.001), 1 year (RR 0.85, p = 0.001), and 2 years (RR 0.82, p = 0.031). A positive PHQ-2 score was predictive of failure to achieve an ODI MCID at 90 days (RR 1.07, p = 0.005) but not at 1 year or 2 years after lumbar fusion.CONCLUSIONSA multivariate analysis based on information from a large, multicenter, prospective database on lumbar fusion patients was performed. The authors found that a positive score (≥ 3) on the PHQ-2, which is a simple and accurate screening tool for depression, predicts an inability to return to work and worse satisfaction up to 2 years after lumbar fusion. Depression is a treatable condition, and so in the same way that patients are medically optimized before surgery to decrease postoperative morbidity, perhaps patients should have preoperative psychiatric optimization to improve postoperative functional outcomes.

The Association of Preoperative Opioid Usage With Patient-Reported Outcomes, Adverse Events, and Return to Work After Lumbar Fusion: Analysis From the Michigan Spine Surgery Improvement Collaborative (MSSIC)

Neurosurgery ◽  
2019 ◽  
Vol 87 (1) ◽  
pp. 142-149 ◽  
Author(s):  
Hesham Mostafa Zakaria ◽  
Tarek R Mansour ◽  
Edvin Telemi ◽  
Karam Asmaro ◽  
Michael Bazydlo ◽  
...  
Keyword(s):  
Adverse Events ◽  
Return To Work ◽  
Spine Surgery ◽  
Lumbar Fusion ◽  
Estimating Equation ◽  
Opioid Use ◽  
Short Term ◽  
Spine Registry ◽  
Patient Reported ◽  
Opioid Users

Abstract BACKGROUND It is important to delineate the relationship between opioid use and spine surgery outcomes. OBJECTIVE To determine the association between preoperative opioid usage and postoperative adverse events, patient satisfaction, return to work, and improvement in Oswestry Disability Index (ODI) in patients undergoing lumbar fusion procedures by using 2-yr data from a prospective spine registry. METHODS Preoperative opioid chronicity from 8693 lumbar fusion patients was defined as opioid-naïve (no usage), new users (&lt;6 wk), short-term users (6 wk-3 mo), intermediate-term users (3-6 mo), and chronic users (&gt;6 mo). Multivariate generalized estimating equation models were constructed. RESULTS All comparisons were to opioid-naïve patients. Chronic opioid users showed less satisfaction with their procedure at 90 d (Relative Risk (RR) 0.95, P = .001), 1 yr (RR 0.89, P = .001), and 2 yr (RR 0.89, P = .005). New opioid users were more likely to show improvement in ODI at 90 d (RR 1.25, P &lt; .001), 1 yr (RR 1.17, P &lt; .001), and 2 yr (RR 1.19, P = .002). Short-term opioid users were more likely to show ODI improvement at 90 d (RR 1.25, P &lt; .001). Chronic opioid users were less likely to show ODI improvement at 90 d (RR 0.90, P = .004), 1 yr (RR 0.85, P &lt; .001), and 2 yr (RR 0.80, P = .003). Chronic opioid users were less likely to return to work at 90 d (RR 0.80, P &lt; .001). CONCLUSION In lumbar fusion patients and when compared to opioid-naïve patients, new opioid users were more likely and chronic opioid users less likely to have improved ODI scores 2 yr after surgery. Chronic opioid users are less likely to be satisfied with their procedure 2 yr after surgery and less likely to return to work at 90 d. Preoperative opioid counseling is advised.

Correlation Between the Oswestry Disability Index and the North American Spine Surgery Patient Satisfaction Index

2020 ◽  
Vol 139 ◽  
pp. e724-e729
Author(s):  
Timothy J. Yee ◽  
Kelsey J. Fearer ◽  
Mark E. Oppenlander ◽  
Osama N. Kashlan ◽  
Nicholas Szerlip ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Spine Surgery ◽  
North American ◽  
Oswestry Disability Index ◽  
Satisfaction Index ◽  
The North ◽  
Surgery Patient

Disparities in outcomes after spine surgery: a Michigan Spine Surgery Improvement Collaborative study

2021 ◽  
pp. 1-9
Author(s):  
Mohamed Macki ◽  
Travis Hamilton ◽  
Seokchun Lim ◽  
Edvin Telemi ◽  
Michael Bazydlo ◽  
...  
Keyword(s):  
African American ◽  
Return To Work ◽  
Spine Surgery ◽  
Collaborative Study ◽  
Lumbar Spine Surgery ◽  
Adjusted Risk ◽  
Satisfaction Index ◽  
The North ◽  
Comorbidity Burden ◽  
Patient Reported

OBJECTIVE Most studies on racial disparities in spine surgery lack data granularity to control for both comorbidities and self-assessment metrics. Analyses from large, multicenter surgical registries can provide an enhanced platform for understanding different factors that influence outcome. In this study, the authors aimed to determine the effects of race on outcomes after lumbar surgery, using patient-reported outcomes (PROs) in 3 areas: the North American Spine Society patient satisfaction index, the minimal clinically important difference (MCID) on the Oswestry Disability Index (ODI) for low-back pain, and return to work. METHODS The Michigan Spine Surgery Improvement Collaborative was queried for all elective lumbar operations. Patient race/ethnicity was categorized as Caucasian, African American, and “other.” Measures of association between race and PROs were calculated with generalized estimating equations (GEEs) to report adjusted risk ratios. RESULTS The African American cohort consisted of a greater proportion of women with the highest comorbidity burden. Among the 7980 and 4222 patients followed up at 1 and 2 years postoperatively, respectively, African American patients experienced the lowest rates of satisfaction, MCID on ODI, and return to work. Following a GEE, African American race decreased the probability of satisfaction at both 1 and 2 years postoperatively. Race did not affect return to work or achieving MCID on the ODI. The variable of greatest association with all 3 PROs at both follow-up times was postoperative depression. CONCLUSIONS While a complex myriad of socioeconomic factors interplay between race and surgical success, the authors identified modifiable risk factors, specifically depression, that may improve PROs among African American patients after elective lumbar spine surgery.

PELAYANAN PUBLIK KESEHATAN PUSKESMAS DALAM MEMBERIKAN KEPUASAN MASYARAKAT DI KABUPATEN SUMENEP

2018 ◽  
Vol 3 (3) ◽  
Author(s):  
Aryo Wibisono ◽  
R. Amilia Destryana
Keyword(s):  
Public Health ◽  
Logistic Regression ◽  
Patient Satisfaction ◽  
Health Center ◽  
Public Service ◽  
Public Health Center ◽  
The Public ◽  
Regression Methods ◽  
Total Satisfaction ◽  
The Relationship

This study aims to determine the index of public satisfaction in public health center services in Sumenep Regency and the relationship between the services to the public satisfaction. The analysis measured the index of public satisfaction and logistic regression methods to determine the effect of the relationship on total satisfaction in the health services of Public Health Center. The results of the study are the alignment between interests and patient satisfaction is still not aligned, there are still differences between interests and satisfaction, the pattern of the result is the relationship between the assurance dimension to the service satisfaction of the public health center, and the results of the index of public satisfaction  values show that the results of the community assess the public health center performance is very good by getting an A grade. Keywords: public service, logistic regretion, index of public satisfaction

Sign in / Sign up

Export Citation Format

Share Document