Exploring clinically relevant risk profiles in patients undergoing lumbar spinal fusion: a cohort study

E.R.C. Janssen*, F.G. Prestigiacomo, E.A.P. van Leent, N.L.U. van Meeteren, M. Hulsbosch

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

Purpose To explore risk profiles of patients scheduled for lumbar spinal fusion (LSF) and their association with short-term recovery of patient after surgery. Methods Forty-nine patients scheduled for elective 1-3 level LSF between March 2019 and June 2020 were included. Patients underwent a preoperative risk screening, consisting of an anamnesis, questionnaires and physical performance tests. A latent profile analysis (LPA) was used to identify possible risk profiles within this population. Results Two risk profiles could be established: a fit and deconditioned risk profile. A significant between-profile difference was found in smoking status (p = 0.007), RAND36-PCS (p < 0.001), Timed Up and Go (TUG) (p < 0.001), de Morton Morbidity Index (DEMMI) (p < 0.001), finger floor distance (p = 0.050), motor control (p = 0.020) and steep ramp test (p = 0.005). Moreover, the fit risk profile had a significant shorter time to functional recovery (3.65 days versus 4.89 days, p = 0.013) and length of hospital stay (5.06 days versus 6.00 days, p = 0.008) compared to the deconditioned risk profile. No differences in complication rates between both risk profiles could be established. Allocation to a risk profile was associated with the functional recovery rate (p = 0.042), but not with LOS or complications. Conclusion This study found a fit and deconditioned risk profile. The patients with a fit risk profile perceived a better quality of life, performed better in mobility, motor control, cardiopulmonary tests and showed also a significant shorter stay in the hospital and a shorter time to functional recovery. Preoperatively establishing a patient's risk profile could aid in perioperative care planning and preoperative decision-making.
Original languageEnglish
Pages (from-to)2473-2480
Number of pages8
JournalEuropean Spine Journal
Volume31
Issue number10
Early online date28 Jul 2022
DOIs
Publication statusPublished - Oct 2022

Keywords

  • Latent class analysis
  • Fitness
  • Spine surgery
  • Lumbar spine
  • Prognosis
  • LOW-BACK-PAIN
  • TOTAL KNEE ARTHROPLASTY
  • PHYSICAL PERFORMANCE
  • EXERCISE
  • OUTCOMES
  • SURGERY
  • COMPLICATIONS
  • ASSOCIATION
  • EVENTS

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