Presenter Status
Resident/Ph.D/Post graduate (> 1 month of dedicated research time)
Abstract Type
Research
Primary Mentor
Richard M. Schwend, M.D.
Start Date
11-5-2023 11:30 AM
End Date
11-5-2023 1:30 PM
Presentation Type
Abstract
Description
Background: There is a growing body of literature assessing the role of preoperative patientreported outcome measures in predicting postoperative achievement of the minimal clinically important difference (MCID). To the best of our knowledge, there are no studies assessing whether preoperative SRS-22 scores are predictive of postoperative achievement of MCID in patient with adolescent idiopathic scoliosis (AIS).
Objectives/Goal: Our purpose is to determine if preoperative SRS-22 scores in patients with AIS who undergo posterior spinal instrumentation and fusion can predict postoperative achievement of MCID.
Methods/Design: SRS-22 forms were provided to all patients scheduled to undergo posterior spinal instrumentation and fusion. MCID was calculated using distribution-based methods. Receiver operator characteristic (ROC) area under the curve (AUC) analysis was performed to assess the predictive probability of SRS-22 scores in predicting postoperative achievement of MCID.
Results: Of 98 patients with preoperative SRS-22 data, 82 (83.7%) completed SRS-22 surveys at 1 year postoperatively. Sixty-six (82.5%) patients were female, average age was 14.9 ± 1.9, and average preoperative Cobb angle was 60 ± 9 degrees. Preoperative global SRS-22 scores were significantly lower in those who achieved MCID compared to those who did not (3.9 vs. 3.5, p=0.0021). MCID for global SRS-22 scores was 0.31. ROC analysis found the following AUCs for each domain:
• Global: 0.72, CI 0.6-0.84 (p=0.001)
• Function: 0.90, CI0.83-0.97 (p< 0.001).
• Pain: 0.76, CI 0.65-0.86 (p< 0.001).
• Mental Health: 0.80 (CI=0.71-0.90, p< 0.001).
• Satisfaction: 0.80 (CI 0.63-0.95, p< 0.001).
• Self-image: 0.62 (CI 0.47-0.77, p=0.15).
Conclusions: Global preoperative SRS-22 and pain subdomain scores are acceptably predictive of postoperative achievement of MCID at one year in AIS patients who undergo posterior spinal fusion and instrumentation. Function, Mental Health, and Satisfaction domains have excellent predictive power at 1 year postoperatively in this population, with the Function domain nearing outstanding predictive ability. With these logistic curves, surgeons can use preoperative SRS-22 scores to predict whether or not their patients will achieve MCID.
MeSH Keywords
Scoliosis; Spine; Instrumentation and Fusion; SRS-22; MCID; Minimal Clinically Important Differnece
Included in
Preoperative SRS-22 Scores Predict Postoperative Achievement of Distribution-Based MCID in AIS Patients Treated with Posterior Spinal Instrumentation and Fusion
Background: There is a growing body of literature assessing the role of preoperative patientreported outcome measures in predicting postoperative achievement of the minimal clinically important difference (MCID). To the best of our knowledge, there are no studies assessing whether preoperative SRS-22 scores are predictive of postoperative achievement of MCID in patient with adolescent idiopathic scoliosis (AIS).
Objectives/Goal: Our purpose is to determine if preoperative SRS-22 scores in patients with AIS who undergo posterior spinal instrumentation and fusion can predict postoperative achievement of MCID.
Methods/Design: SRS-22 forms were provided to all patients scheduled to undergo posterior spinal instrumentation and fusion. MCID was calculated using distribution-based methods. Receiver operator characteristic (ROC) area under the curve (AUC) analysis was performed to assess the predictive probability of SRS-22 scores in predicting postoperative achievement of MCID.
Results: Of 98 patients with preoperative SRS-22 data, 82 (83.7%) completed SRS-22 surveys at 1 year postoperatively. Sixty-six (82.5%) patients were female, average age was 14.9 ± 1.9, and average preoperative Cobb angle was 60 ± 9 degrees. Preoperative global SRS-22 scores were significantly lower in those who achieved MCID compared to those who did not (3.9 vs. 3.5, p=0.0021). MCID for global SRS-22 scores was 0.31. ROC analysis found the following AUCs for each domain:
• Global: 0.72, CI 0.6-0.84 (p=0.001)
• Function: 0.90, CI0.83-0.97 (p< 0.001).
• Pain: 0.76, CI 0.65-0.86 (p< 0.001).
• Mental Health: 0.80 (CI=0.71-0.90, p< 0.001).
• Satisfaction: 0.80 (CI 0.63-0.95, p< 0.001).
• Self-image: 0.62 (CI 0.47-0.77, p=0.15).
Conclusions: Global preoperative SRS-22 and pain subdomain scores are acceptably predictive of postoperative achievement of MCID at one year in AIS patients who undergo posterior spinal fusion and instrumentation. Function, Mental Health, and Satisfaction domains have excellent predictive power at 1 year postoperatively in this population, with the Function domain nearing outstanding predictive ability. With these logistic curves, surgeons can use preoperative SRS-22 scores to predict whether or not their patients will achieve MCID.
