Wednesday, September 26, 2018 7:35 AM–9:00 AM ePosters

Abstract

BACKGROUND CONTEXT The PROMIS provides severity ranges for scores in many domains. These ranges are determined based on the general population, using a normalized mean score of 50 and standard deviation of 10. However, lumbar degenerative patients have worse scores on average compared to the general population, making PROMIS severity ranges clinically meaningless in the care of patients. PURPOSE This study determines PROMIS severity ranges specific to lumbar degenerative patients. STUDY DESIGN/SETTING Retrospective review. PATIENT SAMPLE A total of 407 lumbar degenerative patients with PROMIS Computerized Adaptive Tests (CATs). OUTCOME MEASURES The PROMIS Pain Interference, Physical Function, Fatigue, Anxiety, Depression, Sleep Disturbance, and Satisfaction with Participation in Social Roles CATs. METHODS Preoperative PROMIS scores in Pain Interference, Physical Function, Fatigue, Anxiety, Depression, Sleep Disturbance, and Satisfaction with Participation in Social Roles were obtained for 407 lumbar degenerative patients. To create a severity classification of PROMIS scores specific to lumbar degenerative patients, the average and standard deviation (SD) for each PROMIS domain were calculated for the lumbar degenerative cohort. Scores 1.0-2.0 SD worse than the mean were considered “moderately worse” than the average for lumbar degenerative patients, scores 2.0 or more SD worse than the mean were “severely worse,” and scores 1.0 or more SD better than the mean were “moderately better.” RESULTS A total of 407 lumbar degenerative patients were included (avg. age 57.2 years; 51.8% male; 78.7% White, 12.4% AA, 8.9% other). Average PROMIS score and severity ranges were determined as follows: pain interference average: 64.5, moderately better: 79.2;physical function average: 35.3, moderately better: >43.2, moderately worse: 19.6-27.5, severely worse: 76.9; anxiety average: 53.8, moderately better: 72.7; depression average: 49.6, moderately better: 68.9; sleep disturbance average: 56.0, moderately better: 74.4;satisfaction with participation in social roles average: 40.4, moderately better: >49.0; moderately worse: 23.3-31.8; severely worse: CONCLUSIONS While PROMIS provides severity ranges useful for the general population, on average, lumbar degenerative patients have worse scores than the general population. This analysis provides clinically meaningful PROMIS severity ranges in seven domains for lumbar degenerative patients. These ranges will allow surgeons to better assess severity in their patients and will aid in point-of-care decision-making.