RT Journal Article
SR Electronic
T1 The Patient-Reported Outcome Measurement Information System (PROMIS) Better Reflects the Impact of Length of Stay and the Occurrence of Complications Within 90 Days Than Legacy Outcome Measures for Lumbar Degenerative Surgery
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 82
OP 86
DO 10.14444/8011
VO 15
IS 1
A1 Bortz, Cole
A1 Pierce, Katherine E.
A1 Alas, Haddy
A1 Brown, Avery
A1 Vasquez-Montes, Dennis
A1 Wang, Erik
A1 Varlotta, Christopher G.
A1 Woo, Dainn
A1 Abotsi, Edem J.
A1 Manning, Jordan
A1 Ayres, Ethan W.
A1 Diebo, Bassel G.
A1 Gerling, Michael C.
A1 Buckland, Aaron J.
A1 Passias, Peter G.
YR 2021
UL https://www.ijssurgery.com/content/15/1/82.abstract
AB Background: The Patient-Reported Outcome Measurement Information System (PROMIS) and legacy outcome measures like the Oswestry Disability Index (ODI) have not been compared for their sensitivity in reflecting the impact of perioperative complications and length of stay (LOS) in a surgical thoracolumbar population. The purpose of this study is to assess the strength of PROMIS and ODI scores as they correlate with LOS and complication outcomes of surgical thoracolumbar patients.Methods: Retrospective cohort study. Included: patients ≥18 years undergoing thoracolumbar surgery with available preoperative and 3-month postoperative ODI and PROMIS scores. Pearson correlation assessed the linear relationships between LOS, complications, and scores for PROMIS (physical function, pain intensity, pain interference) and ODI. Linear regression predicted the relationship between complication incidence and scores for ODI and PROMIS.Results: Included: 182 patients undergoing thoracolumbar surgery. Common diagnoses were stenosis (62.1%), radiculopathy (48.9%), and herniated disc (47.8%). Overall, 58.3% of patients underwent fusion, and 50.0% underwent laminectomy. Patients showed preoperative to postoperative improvement in ODI (50.2 to 39.0), PROMIS physical function (10.9 to 21.4), pain intensity (92.4 to 78.3), and pain interference (58.4 to 49.8, all P < .001). Mean LOS was 2.7 ± 2.8 days; overall complication rate was 16.5%. Complications were most commonly cardiac, neurologic, or urinary (all 2.2%). Whereas preoperative to postoperative changes in ODI did not correlate with LOS, changes in PROMIS pain intensity (r = 0.167, P = .024) and physical function (r = −0.169, P = .023) did. Complications did not correlate with changes in ODI or PROMIS score; however, postoperative scores for physical function (r = −0.205, P = .005) and pain interference (r = 0.182, P = .014) both showed stronger correlations with complication occurrence than ODI (r = 0.143, P = .055). Regression analysis showed postoperative physical function (R2 = 0.037, P = .005) and pain interference (R2 = 0.028, P = .014) could predict complications; ODI could not.Conclusions: PROMIS domains of physical function and pain interference better reflected perioperative complications and LOS than the ODI. These results suggest PROMIS may offer more utility as an outcomes assessment instrument.Level of Evidence: 3.