Patient-reported outcome measure completion in lumbar spine surgery: Rates and determinants in a multicenter registry

Patient-reported outcome measures (PROMs) are increasingly used to aid clinical decision-making, evaluate treatment outcomes, and support quality improvement in spine care. However, to ensure valid and representative outcomes, sufficient completion rates are crucial.

The objective of this study is to assess PROM completion rates in routine lumbar spine surgery care and to identify patient- and hospital-level factors associated with completion.

Data were obtained from patients undergoing low-complex lumbar spine surgery for degeneration, with and without instrumentation, recorded in the Spine Tango Registry. PROM completion was assessed as completion of any, baseline, or follow-up PROM, and paired baseline and follow-up PROMs. Mixed-effects logistic regression models were used to evaluate associations between PROM completion and patient characteristics (e.g. age, diagnosis, surgical procedure) and to describe hospital- and country-level variability. Additionally, an exploratory survey among participating hospitals assessed PROM collection strategies.

A total of 1810 patients from 5 countries were included. Overall, 67.3% of patients completed at least one PROM, 57.9% completed a baseline PROM, 53.3% completed a follow-up PROM and 44.4% completed paired baseline and follow-up PROMs. Completion rates declined with increasing follow-up duration. Age, diagnosis, and type of surgery were significantly associated with PROM completion. Substantial variability in PROM completion was observed between hospitals.

PROM completion in routine lumbar spine surgery care remains suboptimal, particularly for long-term follow-up and paired PROMs. The large variability between hospitals indicates that hospital-level interventions are crucial to improve PROM completeness and ensure reliable outcome assessment.