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  • Investigating employment status and education level as factors in patient outcome following lumbar surgery: Single surgeon N2QOD sub-analysis

    Final Number:

    Timothy C. Ryken MD MS FACS; Kelly Ward; Steven Dillavou BS, MS, PA-C; Laura Chapin PhD

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2014 Annual Meeting

    Introduction: Socioeconomic factors influence outcomes following lumbar surgery. We examined level of education, and employment status were significant factors in overall patient satisfaction following lumbar spine surgery.

    Methods: A single-surgeon sub-analysis (n=120) of the N2QOD outcomes analysis based on employment and education was performed. Patient satisfaction, ODI and EQ-5D questionnaires were completed preop, 3 and 12 months postop. Education categories included: Less than high school, High school or GED, 2-year college degree, 4-year college degree, and post-college. Employment categories included: Full-time employment, Part-time employment, Retired, Homemaker, Student, Unemployed, on Disability due to a spinal problem, and on Disability due to a problem other than the spine. Chi-squared and/or ANOVA analysis was performed.

    Results: Comparison of “High school or less”, and “More than high school”, there were no significant differences in ODI or EQ-5D scores, or Satisfaction groups. Employment status was a significant factor in patient Satisfaction at the 3-month time point (Chi-squared, p=0.001), with the Disability group having greater number of Dissatisfied patients than expected. Employment is also a significant factor in ODI and EQ-5D scores (ANOVA, p<0.001), with Disability patients having the worst scores. When comparing the amount of score improvement at 3- and 12-month time points, improvement in ODI scores from Baseline to 3 months, and Baseline to 12 months, employment status was a significant factor (ANOVA, p values less than 0.006). Employment status is also a significant factor in the improvement of EQ-5D scores between Baseline and 12-month scores (ANOVA, p=0.032).

    Conclusions: Highest level of education is not a significant factor in patient satisfaction, ODI or EQ-5D scores following lumbar spine surgery. Patients not on disability leave had better significantly better outcomes. Employment status is a significant factor in patient satisfaction. Unemployed patients, including homemakers, students, and retirees, showed the greatest amount of improvement in ODI scores.

    Patient Care: Improved patient selection and tailored patient care.

    Learning Objectives: Discuss factors leading to patient satisfaction following lumbar spine surgery


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