Weitere Artikel dieser Ausgabe durch Wischen aufrufen
The opinions expressed are those of the authors and are not necessarily those of the Department of Veterans Affairs or the United States Government.
To measure the impact of spinal disorders on health-related quality of life (HRQOL) among Veterans, to describe demographic patterns of Veterans with spinal disorders, and to quantify HRQOL scores as they relate to demographics, medical comorbidities, pain severity, and depressive symptoms.
From 2009 to 2010, 112 lumbar and 56 cervical spinal disorder patients completed SF-12, Oswestry Disability Index, visual analog pain scale, and Beck Depression Inventory surveys. Multivariate analysis identified predictors of HRQOL, disability, and depressive symptoms.
A total of 168 patients completed surveys for this study. The median age of all patients was 60. Nearly 30% of lumbar and 16% of cervical patients were aged 65 or older. Approximately 96% of patients were men. Sixty percent of patients were currently receiving or had pending disability compensation. Nearly 60% of patients were current smokers, approximately 26% reported alcoholism or intravenous drug use, and 26% self-reported post-traumatic stress disorder. The most common lumbar spine diagnoses were disk herniation (36.6%) and stenosis (34.8%), and most common cervical spine diagnoses were stenosis (50.0%) and disk herniation (23.2%). Back pain was reported by 93.8% of lumbar patients and leg pain by 83.0%. Neck pain was reported by 96.4% of cervical patients and arm pain by 69.6%. Median SF-12 physical component scores were more than two standard deviations below the US average. Ninety percent of patients had at least moderate physical disability. Sixty-four percent met criteria for depressive symptoms. Visual analog pain score was the strongest predictor of SF-12 physical (β = −1.32, P < 0.001) and mental (β = −1.63, P < 0.001) HRQOL and was the prime determinant of depressive symptoms (β = 1.52, P < 0.001) and disability index score (β = 4.39, P < 0.0001). Charlson Comorbidity Score and smoking status had no significant impact on HRQOL or disability scores. Age was negatively correlated with depressive symptoms and positively correlated with SF-12 mental component scores.
Spinal disorders have a severe impact on both physical and emotional HRQOL of Veterans and are associated with severe disability and an unusually high prevalence of depressive symptoms. Therapeutic interventions should be targeted to reduce pain, which is a prime determinant of HRQOL, disability, and depressive symptoms. Given high prevalence of multiple risk factors for poor outcomes, studies of spine surgery outcomes in Veterans are needed.
Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten
Sie möchten Zugang zu diesem Inhalt erhalten? Dann informieren Sie sich jetzt über unsere Produkte:
Singh, J. A., & Strand, V. (2009). Health care utilization in patients with spondyloarthropathies. Rheumatology (Oxford), 48(3), 272–276. CrossRef
Luo, J., Zhang, H. T., Jiang, X. D., Xue, S., & Ke, Y. Q. (2009). Combination of bone marrow stromal cell transplantation with mobilization by granulocyte-colony stimulating factor promotes functional recovery after spinal cord transection. Acta Neurochir (Wien), 151(11), 1483–1492. CrossRef
Slover, J., Abdu, W. A., Hanscom, B., Lurie, J., & Weinstein, J. N. (2006). Can condition-specific health surveys be specific to spine disease? An analysis of the effect of comorbidities on baseline condition-specific and general health survey scores. Spine (Phila Pa 1976), 31(11), 1265–1271. CrossRef
Singh, A., Gnanalingham, K., Casey, A., & Crockard, A. (2006). Quality of life assessment using the Short Form-12 (SF-12) questionnaire in patients with cervical spondylotic myelopathy: Comparison with SF-36. Spine (Phila Pa 1976), 31(6), 639–643. CrossRef
Slover, J., Abdu, W. A., Hanscom, B., & Weinstein, J. N. (2006). The impact of comorbidities on the change in short-form 36 and Oswestry scores following lumbar spine surgery. Spine (Phila Pa 1976), 31(17), 1974–1980. CrossRef
Fairbank, J. C., Couper, J., Davies, J. B., & O’Brien, J. P. (1980). The Oswestry low back pain disability questionnaire. Physiotherapy, 66(8), 271–273. PubMed
Vernon, H., & Mior, S. (1991). The neck disability index: A study of reliability and validity. Journal of Manipulative and Physiological Therapeutics, 14(7), 409–415. PubMed
Luo, X., Lynn George, M., Kakouras, I., Edwards, C. L., Pietrobon, R., Richardson, W., et al. (2003). Reliability, validity, and responsiveness of the short form 12-item survey (SF-12) in patients with back pain. Spine (Phila Pa 1976), 28(15), 1739–1745.
Walsh, T. L., Hanscom, B., Lurie, J. D., & Weinstein, J. N. (2003). Is a condition-specific instrument for patients with low back pain/leg symptoms really necessary? The responsiveness of the Oswestry disability index, MODEMS, and the SF-36. Spine (Phila Pa 1976), 28(6), 607–615.
Lustman, P. J., Clouse, R. E., Griffith, L. S., Carney, R. M., & Freedland, K. E. (1997). Screening for depression in diabetes using the Beck depression inventory. Psychosomatic Medicine, 59(1), 24–31. PubMed
Venables, W. N., & Ripley, B. D. (2002). Modern applied statistics with S. New York: Springer. CrossRef
Faraway, J. J. (2005). Linear models with R. New York: Chapman & Hall/CRC.
Gage, H., Hendricks, A., Zhang, S., & Kazis, L. (2003). The relative health related quality of life of veterans with Parkinson’s disease. Journal of Neurology, Neurosurgery and Psychiatry, 74(2), 163–169. CrossRef
Trief, P. M., Ploutz-Snyder, R., & Fredrickson, B. E. (2006). Emotional health predicts pain and function after fusion: A prospective multicenter study. Spine (Phila Pa 1976), 31(7), 823–830. CrossRef
Trief, P. M., Grant, W., & Fredrickson, B. (2000). A prospective study of psychological predictors of lumbar surgery outcome. Spine (Phila Pa 1976), 25(20), 2616–2621. CrossRef
Sinikallio, S., Aalto, T., Lehto, S. M., Airaksinen, O., Herno, A., Kroger, H., et al. (2010). Depressive symptoms predict postoperative disability among patients with lumbar spinal stenosis: A two-year prospective study comparing two age groups. Disability and Rehabilitation, 32(6), 462–468. PubMedCrossRef
Callahan, C. M., Hui, S. L., Nienaber, N. A., Musick, B. S., & Tierney, W. M. (1994). Longitudinal study of depression and health services use among elderly primary care patients. Journal of the American Geriatrics Society, 42(8), 833–838. PubMed
Hankin, C. S., Spiro, A., I. I. I., Miller, D. R., & Kazis, L. (1999). Mental disorders and mental health treatment among U.S. Department of Veterans Affairs outpatients: The Veterans health study. American Journal of Psychiatry, 156(12), 1924–1930. PubMed
Ren, X. S., Kazis, L. E., Lee, A., & Rogers, W. H. (2005). The role of generic and disease-specific measures of physical and role functioning in assessing patient outcomes: a longitudinal study. J Ambul Care Manage, 28(2), 157–166. PubMed
- Health-related quality-of-life status in Veterans with spinal disorders
Stephen L. Skirboll
Robert T. Arrigo
- Springer Netherlands
Neuer Inhalt/© Stellmach, Neuer Inhalt/© Maturus, Pluta Logo/© Pluta