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- Title
Comorbid Conditions As Predictors Of Postoperative Outcome Following Cervical Spine Surgery: A Survey Of United States Orthopaedic And Neurological Surgeons.
- Authors
Gould, Heath; O'Donnell, Jeffrey; Alentado, Vincent; Haines, Colin; Savage, Jason; Mroz, Thomas
- Abstract
Introduction: The direct relationship between comorbid conditions and postoperative outcome following cervical spine surgery has not been well described. Although some clinical data have been presented, there remains a lack of consensus among surgeons regarding the value of common comorbidities as predictors of poor postoperative outcome. The present study seeks to better characterize this discordance by eliciting surgeons' beliefs in the form of a nationally-distributed survey. Methods: An electronic survey was distributed to orthopaedic and neurological surgeons throughout the United States. In addition to providing demographic information, respondents were asked to rate the value of five comorbidities as predictors of poor postoperative outcome following cervical spine surgery. The following comorbidities were surveyed: history of smoking, chronic narcotic use, diabetes, obesity, and psychosocial complication (e.g. depression, anxiety). Study participants recorded their responses using a 5-point Likert scale that ranged from 1 - "very weak predictor" to 5 - "very strong predictor". Results: 247 surgeons completed the survey, including 189 orthopaedic surgeons (76.5%) and 58 neurological surgeons (23.5%). All major U.S. geographical regions were represented. Psychosocial complication (4.04 ± 0.87) and chronic narcotic use (3.91 ± 0.81) were deemed the strongest predictors of poor postoperative outcome, while diabetes (2.71 ± 0.81) and obesity (2.69 ± 0.88) were designated as the weakest predictors. Overall, smoking (3.13 ± 0.91) was the greatest source of discrepancy among responding surgeons. When respondents were stratified according to demographics, there was striking disagreement between specialties. Orthopaedic surgeons and neurological surgeons demonstrated significant discordance with regard to the role of smoking (p < 0.05), narcotic use (p < 0.05), and psychosocial complication (p < 0.05) as predictors of postoperative outcome. Conclusions: Orthopaedic surgeons and neurological surgeons differ in their opinions regarding the role of comorbidities as predictors of outcome following cervical spine surgery. Further studies are needed to investigate the educational and institutional factors underlying this discordance, as well as to determine whether the comorbidities with the highest Likert ratings are indeed the strongest predictors of poor postoperative outcome.
- Publication
Global Spine Journal, 2018, Vol 8, p234S
- ISSN
2192-5682
- Publication type
Article
- DOI
10.1177/2192568218771072