Introduction: Prospective registries have emerged as a feasible way to capture real-world care. However, obtaining real-world outcomes data from patients 12 months after spine surgery remains a challenge. Loss to follow-up is traditionally believed to introduce biases in study results and thought to be associated with poor outcomes. However, follow-up rate and its association with outcomes in degenerative spine population have not been studied. We set out to determine if there is an association between patient demographics&outcomes, and loss to follow-up 12-months after spine surgery.
Methods: All patients undergoing elective spine surgery for degenerative spine disease were enrolled in prospective longitudinal registry. Data was collected on patient demographics, treatment variables, and 90-day morbidity. Patient reported outcome(PRO) instruments were recorded prospectively at baseline, 3-months and 12-months. Multivariate logistic regression was performed to find predictors of loss to follow-up12 months after spine surgery.
Results: 1484 patients were included. 233(15.7%) were lost to follow up at 12months. There was no difference in the baseline characteristics of patients who had follow-up at 12-months vs. not. Patients who were lost to follow-up at 12months were younger and higher proportion of them were employed pre-operatively,Table 1. Pre-operative PROs were similar between the two groups. Similarly, there was no difference in 90-day morbidity(17.2% vs. 16.2%;p=0.70) and 3-month PROs and patient satisfaction between the two groups,Table 1. In multivariate model, only younger age(p<0.001) was an independent predictor of loss to follow-up.
Conclusions: In our real-world prospective registry of spine surgery, 12-month loss to follow-up rate is approximately15%.The only independent predictor of loss to follow-up in degenerative spine population is younger age as people return to work and hinders tracking of long-term outcomes. The proportion of patients lost to follow-up does not introduce any bias in study results and is not associated with worse outcomes or patient dissatisfaction with quality of care.
Patient Care: Our study demonstrates that the only independent predictor of loss to follow-up in degenerative spine population is younger age as people return to work and hinders tracking of long-term outcomes. The proportion of patients lost to follow-up does not introduce any bias in study results and is not associated with worse outcomes or patient dissatisfaction with quality of care.
Learning Objectives: At the end of the session, participants should be able to: 1) Understand the factors associated with loss to follow up after spine surgery