PMID- 36856543
OWN - NLM
STAT- MEDLINE
DCOM- 20230428
LR  - 20230831
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 48
IP  - 10
DP  - 2023 May 15
TI  - Are We Considering the Whole Patient? The Impact of Physical and Mental Health on 
      the Outcomes of Spine Care.
PG  - 720-727
LID - 10.1097/BRS.0000000000004611 [doi]
AB  - STUDY DESIGN: Retrospective, observational. OBJECTIVE: To evaluate the influence 
      of baseline health status on the physical and mental health (MH) outcomes of 
      spine patients. SUMMARY OF BACKGROUND DATA: Spine conditions can have a 
      significant burden on both the physical and MH of patients. To date, few studies 
      have evaluated the outcomes of both dimensions of health, particularly in 
      nonoperative populations. MATERIALS AND METHODS: At their first visit to a 
      multidisciplinary spine clinic, 2668 nonoperative patients completed the 
      Patient-reported Outcomes Measurement Information System-Global Health 
      (PROMIS-GH) instrument and a questionnaire evaluating symptoms and goals of care. 
      Patients were stratified by their baseline percentile score of the MH and 
      physical health (PH) components of the PROMIS-GH. Four groups of patients were 
      compared based on the presence or absence of bottom quartile PH or MH scores. The 
      primary end point was the achievement of a minimal clinically important 
      difference (MCID) on the MH or PH components at follow-up. Multivariate 
      regression assessed the predictors of MCID achievement. RESULTS: After 
      controlling for demographics, symptoms, and goals, each 1-point increase in 
      baseline PROMIS-GH mental score reduced the odds of achieving MH MCID by 9.0% ( P 
      <0.001). Conversely, each 1-point increase in baseline GH-physical score 
      increased the odds of achieving MCID by 4.5% ( P =0.005). Each 1-point increase 
      in baseline GH-physical score reduced the odds of achieving PH MCID by 12.5% ( P 
      <0.001), whereas each 1-point increase in baseline GH-mental score increased the 
      odds of achieving MCID by 5.0% ( P <0.001). CONCLUSIONS: Spine patients 
      presenting with the lowest levels of physical or MH were most likely to 
      experience clinically significant improvement in those domains. However, lower 
      levels of physical or mental health made it less likely that patients would 
      experience significant improvement in the alternative domain. Physicians should 
      evaluate and address the complex spine population holistically to maximize 
      improvement in both physical and mental health status.
CI  - Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Turcotte, Justin J
AU  - Turcotte JJ
AUID- ORCID: 0000-0002-5591-8033
AD  - Department of Orthopedics, Luminis Health Anne Arundel Medical Center, Annapolis, 
      MD.
FAU - Baxter, Samantha
AU  - Baxter S
FAU - Pipkin, Karen
AU  - Pipkin K
FAU - Patton, Chad M
AU  - Patton CM
LA  - eng
PT  - Journal Article
DEP - 20230227
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - Humans
MH  - *Mental Health
MH  - Retrospective Studies
MH  - Spine
MH  - *Spinal Diseases/diagnosis/therapy
MH  - Health Status
MH  - Treatment Outcome
MH  - Patient Reported Outcome Measures
MH  - Minimal Clinically Important Difference
COIS- C.M.P. receives consulting payments from Medtronic, unrelated to the current 
      study. The remaining authors report no conflicts of interest.
EDAT- 2023/03/02 06:00
MHDA- 2023/04/28 06:42
CRDT- 2023/03/01 09:42
PHST- 2022/12/13 00:00 [received]
PHST- 2023/02/07 00:00 [accepted]
PHST- 2023/04/28 06:42 [medline]
PHST- 2023/03/02 06:00 [pubmed]
PHST- 2023/03/01 09:42 [entrez]
AID - 00007632-202305150-00009 [pii]
AID - 10.1097/BRS.0000000000004611 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2023 May 15;48(10):720-727. doi: 
      10.1097/BRS.0000000000004611. Epub 2023 Feb 27.