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• W4386041808 abstract "BACKGROUND CONTEXT A substantial number of Canadian spine surgery patients presenting with degenerative surgical pathology have preexisting compensation claims. These claims can include, for example, disability or provincial workers compensation claims. Compensation claims are an independent risk factor for poor postoperative satisfaction. PURPOSE This study aims to identify predictors of poor postoperative satisfaction in spine surgery patients with compensation claims. STUDY DESIGN/SETTING Prospective multicenter registry. PATIENT SAMPLE The Canadian Spine Outcomes and Research Network (CSORN) prospective spine registry was utilized. METHODS The CSORN prospective spine registry was utilized. Surgical patients with degenerative cervical and thoracolumbar pathology who reported at least one compensation claim and completed one year follow up were included. We excluded patients with a diagnosis of tumor, trauma, and infection, and those with missing postoperative satisfaction status. Compensation claims included: workers compensation, legal consultations, and insurance claims Satisfaction was measured one-year postsurgery. Poor satisfaction was defined as “extremely dissatisfied”, “somewhat dissatisfied” and “neither satisfied nor dissatisfied”. Multivariate logistic regression modeling was used to build a prediction model of poor satisfaction. Potential predictors were identified using univariate analysis. The model was built using a combination of backward elimination and bootstrap selection. Model fit was assessed using the Hosmer-Lemeshow test and the C statistic / ROC curve. Split sample internal cross-validation was performed. RESULTS A total of 1,190 patients with compensation claims were included. One year postoperatively, 232/1190 (19.5%) patients were not satisfied. Multivariate logistic regression identified independent predictors of poor satisfaction. The following predictors were associated with higher odds of poor satisfaction: preoperative opioid use (daily OR 1.64 p=0.041, weekly OR 1.90 p=0.02), longer wait time for surgery (p=0.015), major intraoperative adverse events (OR 4.4, p=0.042), postoperative adverse events (OR 2.11, p=0.003), and lower preoperative SF-12 MCS (p=0.0001). The following predictors were associated with lower odds of poor satisfaction: higher education (undergraduate and postgraduate, OR 0.54, p=0.004), exercising at least once a week (OR 0.66, p=0.037), and having an “insurance” type of claim (OR 0.61, p=0.014). The predictive model had a good discrimination (ROC curve 0.72), and good calibration (Hosmer-Lemeshow p=0.27), which held true when performing split-sample cross-validation CONCLUSIONS A total of, 20% of spine surgery patients with preexisting compensation claims were not satisfied with their postoperative outcome at one year. This study identified predictors of poor patient satisfaction in this cohort. FDA Device/Drug Status This abstract does not discuss or include any applicable devices or drugs. A substantial number of Canadian spine surgery patients presenting with degenerative surgical pathology have preexisting compensation claims. These claims can include, for example, disability or provincial workers compensation claims. Compensation claims are an independent risk factor for poor postoperative satisfaction. This study aims to identify predictors of poor postoperative satisfaction in spine surgery patients with compensation claims. Prospective multicenter registry. The Canadian Spine Outcomes and Research Network (CSORN) prospective spine registry was utilized. The CSORN prospective spine registry was utilized. Surgical patients with degenerative cervical and thoracolumbar pathology who reported at least one compensation claim and completed one year follow up were included. We excluded patients with a diagnosis of tumor, trauma, and infection, and those with missing postoperative satisfaction status. Compensation claims included: workers compensation, legal consultations, and insurance claims Satisfaction was measured one-year postsurgery. Poor satisfaction was defined as “extremely dissatisfied”, “somewhat dissatisfied” and “neither satisfied nor dissatisfied”. Multivariate logistic regression modeling was used to build a prediction model of poor satisfaction. Potential predictors were identified using univariate analysis. The model was built using a combination of backward elimination and bootstrap selection. Model fit was assessed using the Hosmer-Lemeshow test and the C statistic / ROC curve. Split sample internal cross-validation was performed. A total of 1,190 patients with compensation claims were included. One year postoperatively, 232/1190 (19.5%) patients were not satisfied. Multivariate logistic regression identified independent predictors of poor satisfaction. The following predictors were associated with higher odds of poor satisfaction: preoperative opioid use (daily OR 1.64 p=0.041, weekly OR 1.90 p=0.02), longer wait time for surgery (p=0.015), major intraoperative adverse events (OR 4.4, p=0.042), postoperative adverse events (OR 2.11, p=0.003), and lower preoperative SF-12 MCS (p=0.0001). The following predictors were associated with lower odds of poor satisfaction: higher education (undergraduate and postgraduate, OR 0.54, p=0.004), exercising at least once a week (OR 0.66, p=0.037), and having an “insurance” type of claim (OR 0.61, p=0.014). The predictive model had a good discrimination (ROC curve 0.72), and good calibration (Hosmer-Lemeshow p=0.27), which held true when performing split-sample cross-validation A total of, 20% of spine surgery patients with preexisting compensation claims were not satisfied with their postoperative outcome at one year. This study identified predictors of poor patient satisfaction in this cohort." @default.
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• W4386041808 date "2023-09-01" @default.
• W4386041808 modified "2023-10-09" @default.
• W4386041808 title "178. Predictors of poor postoperative patient satisfaction in elective spine patients with preexisting compensation claims" @default.
• W4386041808 doi "https://doi.org/10.1016/j.spinee.2023.06.200" @default.
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