PMID- 31443085
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240517
IS  - 1547-5646 (Electronic)
IS  - 1547-5646 (Linking)
VI  - 31
IP  - 6
DP  - 2019 Aug 23
TI  - 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.
PG  - 794-801
LID - 10.3171/2019.6.SPINE1963 [doi]
AB  - OBJECTIVE: The 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. METHODS: Data 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. RESULTS: Multivariate 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. 
      CONCLUSIONS: A 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.
FAU - Zakaria, Hesham Mostafa
AU  - Zakaria HM
AD  - 1Department of Neurosurgery.
FAU - Mansour, Tarek R
AU  - Mansour TR
AD  - 1Department of Neurosurgery.
FAU - Telemi, Edvin
AU  - Telemi E
AD  - 1Department of Neurosurgery.
FAU - Asmaro, Karam
AU  - Asmaro K
AD  - 1Department of Neurosurgery.
FAU - Macki, Mohamed
AU  - Macki M
AD  - 1Department of Neurosurgery.
FAU - Bazydlo, Michael
AU  - Bazydlo M
AD  - 2Center for Health Services Research, and.
FAU - Schultz, Lonni
AU  - Schultz L
AD  - 2Center for Health Services Research, and.
FAU - Nerenz, David R
AU  - Nerenz DR
AD  - 3Department of Public Health Sciences, Henry Ford Hospital, Detroit; and.
FAU - Abdulhak, Muwaffak
AU  - Abdulhak M
AD  - 1Department of Neurosurgery.
FAU - Schwalb, Jason M
AU  - Schwalb JM
AD  - 1Department of Neurosurgery.
FAU - Park, Paul
AU  - Park P
AD  - 4Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan.
FAU - Chang, Victor
AU  - Chang V
AD  - 1Department of Neurosurgery.
LA  - eng
PT  - Journal Article
DEP - 20190823
PL  - United States
TA  - J Neurosurg Spine
JT  - Journal of neurosurgery. Spine
JID - 101223545
SB  - IM
OTO - NOTNLM
OT  - back pain
OT  - depression
OT  - disability
OT  - lumbar
OT  - patient-reported outcome measures
OT  - quality of life
OT  - return to work
OT  - spinal fusion
EDAT- 2019/08/24 06:00
MHDA- 2019/08/24 06:01
CRDT- 2019/08/24 06:00
PHST- 2019/01/22 00:00 [received]
PHST- 2019/06/05 00:00 [accepted]
PHST- 2019/08/24 06:01 [medline]
PHST- 2019/08/24 06:00 [pubmed]
PHST- 2019/08/24 06:00 [entrez]
AID - 2019.6.SPINE1963 [pii]
AID - 10.3171/2019.6.SPINE1963 [doi]
PST - epublish
SO  - J Neurosurg Spine. 2019 Aug 23;31(6):794-801. doi: 10.3171/2019.6.SPINE1963.