PMID- 37941112 OWN - NLM STAT- MEDLINE DCOM- 20240228 LR - 20240416 IS - 2380-0194 (Electronic) IS - 2380-0186 (Linking) VI - 37 IP - 2 DP - 2024 Mar 1 TI - Impact of American Society of Anesthesiologists' Classification on Postoperative Satisfaction and Clinical Outcomes Following Lumbar Decompression: Cohort-Matched Analysis. PG - E89-E96 LID - 10.1097/BSD.0000000000001553 [doi] AB - STUDY DESIGN: Retrospective cohort. OBJECTIVE: The aim was to compare patient-reported outcomes (PROMs), minimum clinically important difference (MCID) achievement, and postoperative satisfaction following minimally invasive lumbar decompression in patients stratified by American Society of Anesthesiologists (ASA) classification. SUMMARY OF BACKGROUND DATA: Some guidelines recommend against performing elective procedures for patients with an ASA score of 3 or greater; however, long-term postoperative outcomes are not well described. METHODS: Primary, single-level, minimally invasive lumbar decompression procedures were identified. PROMs were administered at preoperative, 6-week, 12-week, 6-month, 1-year, 2-year timepoints and included Patient-Reported Outcomes Measurement Information System-Physical Function, visual analog scale (VAS) back/leg, Oswestry disability index (ODI), and 12-item short form physical component score. Satisfaction scores were collected postoperatively for VAS back/leg, ODI, and individual ODI subcategories. Patients were grouped (ASA<3, ASA>/=3), and propensity scores were matched to control for significant differences. Demographic and perioperative characteristics were compared using chi 2 and the Student's t test. Mean PROMs and postoperative satisfaction were compared at each time point by a 2-sample t test. Postoperative PROM improvement from the preoperative baseline within each cohort was calculated with a paired t test. MCID achievement was determined by comparing DeltaPROMs to established thresholds and comparing between groups using simple logistic regression. RESULTS: One hundred and twenty-nine propensity-matched patients were included: 99 ASA<3 and 30 ASA>/=3. No significant demographic differences were observed between groups. ASA>/=3 patients experienced significantly increased length of stay and postoperative narcotic consumption on surgery day ( P <0.048, all). Mean PROMs and MCID achievement did not differ. The ASA<3 cohort significantly improved from the preoperative baseline for all PROMs at all postoperative time points. ASA<3 patients demonstrated higher levels of postoperative satisfaction at 6 weeks for VAS leg, VAS back, ODI, sleeping, lifting, walking, standing, sex, travel, and at 6 months for VAS back ( P <0.045, all). CONCLUSION: ASA>/=3 patients may achieve similar long-term clinical outcomes to ASA<3 patients, though they may show poorer short-term satisfaction for disability, leg pain, and back pain, which could be related to differing preoperative expectations. CI - Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved. FAU - Jacob, Kevin C AU - Jacob KC AD - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL. FAU - Patel, Madhav R AU - Patel MR FAU - Nie, James W AU - Nie JW FAU - Hartman, Timothy J AU - Hartman TJ FAU - Vanjani, Nisheka N AU - Vanjani NN FAU - Pawlowski, Hanna AU - Pawlowski H FAU - Prabhu, Michael C AU - Prabhu MC FAU - Singh, Kern AU - Singh K LA - eng PT - Journal Article DEP - 20231030 PL - United States TA - Clin Spine Surg JT - Clinical spine surgery JID - 101675083 SB - IM MH - Humans MH - Retrospective Studies MH - *Anesthesiologists MH - Back Pain/surgery/etiology MH - Decompression, Surgical MH - Lumbar Vertebrae/surgery MH - Treatment Outcome MH - *Spinal Fusion/methods COIS- The authors declare no conflict of interest. EDAT- 2023/11/09 06:41 MHDA- 2024/02/28 06:44 CRDT- 2023/11/09 00:13 PHST- 2022/07/14 00:00 [received] PHST- 2023/10/03 00:00 [accepted] PHST- 2024/02/28 06:44 [medline] PHST- 2023/11/09 06:41 [pubmed] PHST- 2023/11/09 00:13 [entrez] AID - 01933606-990000000-00230 [pii] AID - 10.1097/BSD.0000000000001553 [doi] PST - ppublish SO - Clin Spine Surg. 2024 Mar 1;37(2):E89-E96. doi: 10.1097/BSD.0000000000001553. Epub 2023 Oct 30.