在腰部减压后达到最低临床重要差异的时间
James W Nie1, Vincent P Federico1, Timothy J Hartman1
1Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St. Suite #300, Chicago, IL, 60612, USA.
Acta neurochirurgica
|July 24, 2023
概括
吸烟和基线功能等因素预测腰部减压后的早期恢复. 相反,保险类型和诊断等因素会影响延迟恢复,帮助外科医生管理患者对腰部减压结果的期望.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 患者报告的结果.
- 临床结果研究研究的临床结果.
背景情况:
- 腰部减压 (LD) 是一个常见的脊柱疾病的手术程序.
- 使用临床重要差异最小值 (MCID) 评估患者康复对于评估手术成功至关重要.
- 了解影响MCID实现时间的因素可以优化患者的护理和期望.
研究的目的:
- 调查与奥斯韦斯特里残疾指数 (ODI),视觉模拟尺度 (VAS) 背部和LD后VAS腿部疼痛实现MCID的时间相关的术前因素.
- 在接受LD的患者中确定早期与晚期MCID成就的预测因素.
主要方法:
- 从2016年4月到2021年1月,对343名从2016年4月到2021年1月接受LD的患者进行了回顾性审查.
- 使用已建立的MCID值来确定实现.
- 使用卡普兰-梅尔生存分析和多变量考克斯回归来分析到MCID的时间,并确定预测因素.
主要成果:
- 在ODI,VAS背部和VAS腿部,总的MCID成功率约为65-67%.
- 实现MCID的平均时间大约在19至23周之间.
- 积极吸烟,基线PROMIS-PF,ODI,VAS背部和VAS腿部预测了早期的MCID成就.
- ASA类2,黑人族裔,工人赔偿,私人保险和前狭窄症诊断预测了晚期MCID的实现.
结论:
- 大多数患者在LD后六个月内实现了MCID.
- 积极吸烟和患者报告的基线结果是早期康复的重要预测因素.
- 人口因素,保险状况和特定的诊断影响了实现有意义改善的时间表.
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