Spine · 2024
The PROMIS-10 Mental Health T-Score: An Independent Predictor of Recovery for Up to 1 Year After Elective Lumbar Spine Fusion.
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Solomito Matthew J, Kostyun Regina O, Makanji Heeren
Аннотация
STUDY DESIGN: Retrospective comparative cohort.
OBJECTIVE: Investigate how mental health, as measured by the PROMIS-10 Global Mental Health T-Score (MHT), influences a patient's recovery up to 1 year after elective lumbar fusion.
SUMMARY OF BACKGROUND DATA: Patients with mental health concerns in need of lumbar fusions have increased. Evidence suggests that mental disorders influence a patient's postoperative recovery; however, there is a paucity of information detailing the association between mental health and outcomes.
METHODS: A total of 351 patients who underwent 1- or 2-level elective lumbar fusion between April 2020 and June 2023 and completed all follow-up evaluations for up to 1 year postfusion were analyzed for this study. Patients were stratified by their MHT score (above average [AA] >50, average [A] 40-50, below average [BA] <40), regardless of mental illness diagnosis. Outcome measures including pain at hospital discharge and 3, 6, and 12 months after fusion, patient satisfaction, and the Oswestry Disability Index (ODI) score at 3, 6, and 12 months after fusion were compared among groups.
RESULTS: Nearly 20% of patients reported below-average mental health during their preoperative evaluation. After controlling for confounders, findings suggested that patients in the [BA] group reported 2 pain levels higher than the [AA] group at each time point and 1 point higher than the [A] group. Patients in the [BA] group performed worse on the ODI at all-time points compared with the other study groups. Patients in the [AA] group were 3 times more likely to be satisfied with their outcomes compared with the [BA] group.
CONCLUSION: The MHT was an independent predictor of pain, satisfaction, and ODI scores for up to 1 year post-fusion, while a mental disorder diagnosis was not. An MHT score below 40 may be a risk factor for patients undergoing elective lumbar fusion.
OBJECTIVE: Investigate how mental health, as measured by the PROMIS-10 Global Mental Health T-Score (MHT), influences a patient's recovery up to 1 year after elective lumbar fusion.
SUMMARY OF BACKGROUND DATA: Patients with mental health concerns in need of lumbar fusions have increased. Evidence suggests that mental disorders influence a patient's postoperative recovery; however, there is a paucity of information detailing the association between mental health and outcomes.
METHODS: A total of 351 patients who underwent 1- or 2-level elective lumbar fusion between April 2020 and June 2023 and completed all follow-up evaluations for up to 1 year postfusion were analyzed for this study. Patients were stratified by their MHT score (above average [AA] >50, average [A] 40-50, below average [BA] <40), regardless of mental illness diagnosis. Outcome measures including pain at hospital discharge and 3, 6, and 12 months after fusion, patient satisfaction, and the Oswestry Disability Index (ODI) score at 3, 6, and 12 months after fusion were compared among groups.
RESULTS: Nearly 20% of patients reported below-average mental health during their preoperative evaluation. After controlling for confounders, findings suggested that patients in the [BA] group reported 2 pain levels higher than the [AA] group at each time point and 1 point higher than the [A] group. Patients in the [BA] group performed worse on the ODI at all-time points compared with the other study groups. Patients in the [AA] group were 3 times more likely to be satisfied with their outcomes compared with the [BA] group.
CONCLUSION: The MHT was an independent predictor of pain, satisfaction, and ODI scores for up to 1 year post-fusion, while a mental disorder diagnosis was not. An MHT score below 40 may be a risk factor for patients undergoing elective lumbar fusion.