P134. Preoperative PROMIS scores can predict patient satisfaction following surgery for cervical degeneration

Abstract

BACKGROUND CONTEXT Satisfaction with treatment is a primary goal of health care providers. However, factors contributing to patient satisfaction in cervical spine surgery are poorly understood. Preoperative identification of patients likely to be satisfied with surgery can help guide treatment, and set appropriate patient expectations. This study examines whether preoperative PROMIS scores can predict postoperative satisfaction with treatment in patients undergoing surgery for cervical degeneration. PURPOSE To determine whether preoperative PROMIS scores can predict patient satisfaction with treatment after 1 year following surgery for cervical degeneration. STUDY DESIGN/SETTING Restrospective review. PATIENT SAMPLE A total of 86 surgical cervical degeneration patients. OUTCOME MEASURES NASS Patient Satisfaction Index. METHODS Patients undergoing surgery for cervical degeneration in 2015-2018 with minimum 1-year follow-up were evaluated. PROMIS questionnaires were obtained preoperatively and at 1 year postoperatively. NASS Patient Satisfaction Index (PSI) scores were obtained at the postoperative encounter. To determine whether preoperative data could be used to predict patient satisfaction at 1-year postoperatively, we performed a logistic regression analysis using with NASS PSI as outcome, including all preoperative PROMIS scores as well as age, gender and race. PROMIS domains assessed were pain interference, physical function, anxiety, depression, fatigue, sleep disturbance and satisfaction with participation in social roles. RESULTS A total of 86 patients undergoing surgery for cervical degeneration (mean age 63.6 years) were included. At 12 months, 56% (48/86) reported that “the treatment met their expectations,” as outlined by NASS PSI scores. Logistic regression analysis showed that low preoperative PROMIS depression (OR=0.96, CI=[0.93, 0.99], p=0.008) and high preoperative PROMIS satisfaction with participation in social roles led to increased NASS PSI (OR= 1.03, CI=[1.01, 1.07], p=0.04) scores. Also, white race was found to lead to higher NASS PSI scores (OR= 8.69, CI=[1.49, 50.6], p=0.02). No significant relationships were found with respect to preoperative PROMIS pain interference, physical function, anxiety, sleep disturbance, age or gender. CONCLUSIONS Low preoperative PROMIS depression and high preoperative PROMIS satisfaction with participation in social roles can predict patient satisfaction with treatment following surgery for cervical degeneration, as measured by NASS PSI. Thus, patients with few depressive symptoms and a strong social support system preoperatively are most likely to be satisfied with surgical treatment. Also, white race can predict higher patient satisfaction. By assessing preoperative PROMIS scores and demographic data, clinicians may be better equipped to identify patients likely to be satisfied, and inform point-of-care shared decision-making. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.