PMID- 37154697
OWN - NLM
STAT- Publisher
LR  - 20231221
IS  - 2192-5682 (Print)
IS  - 2192-5682 (Linking)
DP  - 2023 May 8
TI  - Independent Prognostic Factors Associated With Improved Patient-Reported Outcomes 
      in the Prospective Evaluation of Elderly Deformity Surgery (PEEDS) Study.
PG  - 21925682231174182
LID - 10.1177/21925682231174182 [doi]
AB  - STUDY DESIGN: Prospective, multicenter, international, observational study. 
      OBJECTIVE: Identify independent prognostic factors associated with achieving the 
      minimal clinically important difference (MCID) in patient reported outcome 
      measures (PROMs) among adult spinal deformity (ASD) patients >/=60 years of age 
      undergoing primary reconstructive surgery. METHODS: Patients >/=60 years undergoing 
      primary spinal deformity surgery having >/=5 levels fused were recruited for this 
      study. Three approaches were used to assess MCID: (1) absolute change:0.5 point 
      increase in the SRS-22r sub-total score/0.18 point increase in the EQ-5D index; 
      (2) relative change: 15% increase in the SRS-22r sub-total/EQ-5D index; (3) 
      relative change with a cut-off in the outcome at baseline: similar to the 
      relative change with an imposed baseline score of </=3.2/0.7 for the SRS-22r/EQ-5D, 
      respectively. RESULTS: 171 patients completed the SRS-22r and 170 patients 
      completed the EQ-5D at baseline and at 2 years postoperative. Patients who 
      reached MCID in the SRS-22r self-reported more pain and worse health at baseline 
      in both approaches (1) and (2). Lower baseline PROMs ((1) - OR: .01 [.00-.12]; 
      (2)- OR: .00 [.00-.07]) and number of severe adverse events (AEs) ((1) - OR: .48 
      [.28-.82]; (2)- OR: .39 [.23-.69]) were the only identified risk factors. 
      Patients who reached MCID in the EQ-5D demonstrated similar characteristics 
      regarding pain and health at baseline as the SRS-22r using approaches (1) and 
      (2). Higher baseline ODI ((1) - OR: 1.05 [1.02-1.07]) and number of severe AEs 
      (OR: .58 [.38-.89]) were identified as predictive variables. Patients who reached 
      MCID in the SRS22r experienced worse health at baseline using approach (3). The 
      number of AEs (OR: .44 [.25-.77]) and baseline PROMs (OR: .01 [.00-.22] were the 
      only identified predictive factors. Patients who reached MCID in the EQ-5D 
      experienced less AEs and a lower number of actions taken due to the occurrence of 
      AEs using approach (3). The number of actions taken due to AEs (OR: .50 
      [.35-.73]) was found to be the only predictive variable factor. No surgical, 
      clinical, or radiographic variables were identified as risk factors using either 
      of the aforementioned approaches. CONCLUSION: In this large multicenter 
      prospective cohort of elderly patients undergoing primary reconstructive surgery 
      for ASD, baseline health status, AEs, and severity of AEs were predictive of 
      reaching MCID. No clinical, radiological, or surgical parameters were identified 
      as factors that can be prognostic for reaching MCID.
FAU - Hassan, Fthimnir M
AU  - Hassan FM
AUID- ORCID: 0000-0003-3928-8972
AD  - Department of Orthopaedic Surgery, The Och Spine Hospital/Columbia University 
      Irving Medical Center, New York, NY, USA. RINGGOLD: 21611
FAU - Lenke, Lawrence G
AU  - Lenke LG
AD  - Department of Orthopaedic Surgery, The Och Spine Hospital/Columbia University 
      Irving Medical Center, New York, NY, USA. RINGGOLD: 21611
FAU - Berven, Sigurd H
AU  - Berven SH
AD  - Department of Orthopaedic Surgery, University of California San Francisco, San 
      Francisco, CA, USA. RINGGOLD: 8785
FAU - Kelly, Michael P
AU  - Kelly MP
AD  - Department of Orthopaedic Surgery, Rady Children's Hospital, San Diego, CA, USA.
FAU - Smith, Justin S
AU  - Smith JS
AD  - Department of Neurosurgery, University of Virginia Medical Center, 
      Charlottesville, VA, USA. RINGGOLD: 21673
FAU - Shaffrey, Christopher I
AU  - Shaffrey CI
AD  - Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA. 
      RINGGOLD: 3065
FAU - Dahl, Benny T
AU  - Dahl BT
AD  - Department of Orthopaedic Surgery, Texas Children's Hospital, Bellaire, TX, USA.
FAU - de Kleuver, Marinus
AU  - de Kleuver M
AD  - Department of Orthopedics, Radboud University Medical Center, The Netherlands.
FAU - Spruit, Maarten
AU  - Spruit M
AD  - Department of Orthopedics, Sint Maartenskliniek, The Netherlands. RINGGOLD: 6033
FAU - Pellise, Ferran
AU  - Pellise F
AUID- ORCID: 0000-0002-0644-7757
AD  - Department of Orthopaedic Surgery, Vall D'Hebron University Hospital, Spain.
FAU - Cheung, Kenneth M C
AU  - Cheung KMC
AUID- ORCID: 0000-0001-8304-0419
AD  - Department of Orthopaedic Surgery, Hong Kong University Schenzhen Hospital, Hong 
      Kong, China. RINGGOLD: 25809
FAU - Alanay, Ahmet
AU  - Alanay A
AD  - Department of Orthopedics, Acibadem Mehmet ali Aydinlar University School of 
      Medicine, Turkey.
FAU - Polly, David W Jr
AU  - Polly DW Jr
AD  - Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA. 
      RINGGOLD: 5635
FAU - Sembrano, Jonathan
AU  - Sembrano J
AD  - Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA. 
      RINGGOLD: 5635
FAU - Matsuyama, Yukihiro
AU  - Matsuyama Y
AD  - Department of Orthopaedic Surgery, Hamatsu University School of Medicine, 
      Hamatsu, Japan.
FAU - Qiu, Yong
AU  - Qiu Y
AUID- ORCID: 0000-0003-4202-6092
AD  - Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical 
      School, China.
FAU - Lewis, Stephen J
AU  - Lewis SJ
AUID- ORCID: 0000-0002-9173-8443
AD  - Department of Orthopaedic Surgery, University of Toronto, Toronto, Canada.
CN  - AO Spine Knowledge Forum Deformity
LA  - eng
PT  - Journal Article
DEP - 20230508
PL  - England
TA  - Global Spine J
JT  - Global spine journal
JID - 101596156
OTO - NOTNLM
OT  - adults
OT  - elderly
OT  - health measures
OT  - minimal clinically important difference
OT  - patient reported outcome
OT  - spine deformity
OT  - spine surgery
COIS- Declaration of Conflicting InterestsThe author(s) declared no potential conflicts 
      of interest with respect to the research, authorship, and/or publication of this 
      article.
EDAT- 2023/05/08 13:42
MHDA- 2023/05/08 13:42
CRDT- 2023/05/08 10:04
PHST- 2023/05/08 13:42 [pubmed]
PHST- 2023/05/08 13:42 [medline]
PHST- 2023/05/08 10:04 [entrez]
AID - 10.1177/21925682231174182 [doi]
PST - aheadofprint
SO  - Global Spine J. 2023 May 8:21925682231174182. doi: 10.1177/21925682231174182.