The impact of psychiatric comorbidity on the return to work in patients undergoing herniated disc surgery

Zieger, Margrit; Luppa, M; Meisel, Hans Jörg; Günther, Lutz; Meixensberger, Juergen; Toussaint, René; König, HH; Riedel-Heller, SG

doi:10.1055/s-0031-1277937

Cited by 6 publications

(7 citation statements)

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“…Patients with a higher educational status are more likely to be engaged in professional ca- reers, which theoretically makes RTW easier due to less demanding physical work. 68 Furthermore, a higher education level may also allow for a better understanding of disease processes, which may result in these patients forming more realistic postoperative expectations, being more treatment compliant, and achieving better recoveries. 40,53…”

Section: Education Levelmentioning

confidence: 99%

An analysis from the Quality Outcomes Database, Part 2. Predictive model for return to work after elective surgery for lumbar degenerative disease

Asher

Devin

Archer

et al. 2017

Journal of Neurosurgery: Spine

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OBJECTIVECurrent costs associated with spine care are unsustainable. Productivity loss and time away from work for patients who were once gainfully employed contributes greatly to the financial burden experienced by individuals and, more broadly, society. Therefore, it is vital to identify the factors associated with return to work (RTW) after lumbar spine surgery. In this analysis, the authors used data from a national prospective outcomes registry to create a predictive model of patients’ ability to RTW after undergoing lumbar spine surgery for degenerative spine disease.METHODSData from 4694 patients who underwent elective spine surgery for degenerative lumbar disease, who had been employed preoperatively, and who had completed a 3-month follow-up evaluation, were entered into a prospective, multicenter registry. Patient-reported outcomes—Oswestry Disability Index (ODI), numeric rating scale (NRS) for back pain (BP) and leg pain (LP), and EQ-5D scores—were recorded at baseline and at 3 months postoperatively. The time to RTW was defined as the period between operation and date of returning to work. A multivariable Cox proportional hazards regression model, including an array of preoperative factors, was fitted for RTW. The model performance was measured using the concordance index (c-index).RESULTSEighty-two percent of patients (n = 3855) returned to work within 3 months postoperatively. The risk-adjusted predictors of a lower likelihood of RTW were being preoperatively employed but not working at the time of presentation, manual labor as an occupation, worker’s compensation, liability insurance for disability, higher preoperative ODI score, higher preoperative NRS-BP score, and demographic factors such as female sex, African American race, history of diabetes, and higher American Society of Anesthesiologists score. The likelihood of a RTW within 3 months was higher in patients with higher education level than in those with less than high school–level education. The c-index of the model’s performance was 0.71.CONCLUSIONSThis study presents a novel predictive model for the probability of returning to work after lumbar spine surgery. Spine care providers can use this model to educate patients and encourage them in shared decision-making regarding the RTW outcome. This evidence-based decision support will result in better communication between patients and clinicians and improve postoperative recovery expectations, which will ultimately increase the likelihood of a positive RTW trajectory.

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Section: Education Levelmentioning

confidence: 99%

An analysis from the Quality Outcomes Database, Part 2. Predictive model for return to work after elective surgery for lumbar degenerative disease

Asher

Devin

Archer

et al. 2017

Journal of Neurosurgery: Spine

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“…Often, persons in VR experience a lot of minor limitations during their working life, which in the end leads to a loss of work ability or decrease in work participation. Co-morbidities not only seem to lower quality of life, they also appear to be a major risk factor for unsuccessful return to work [23,42]. This cross-sectional study has provided us with broad lists of ICF categories that are relevant to the patients' lived experience and that cover functioning at the individual and societal level.…”

Section: Discussionmentioning

confidence: 99%

Identification of Relevant ICF Categories in Vocational Rehabilitation: A Cross Sectional Study Evaluating the Clinical Perspective

et al. 2011

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“…The return-to-work rates 3 months, 1 year, and 8 years after surgical treatment are 44.4%-100%, 72%-89.9%, and 82.5%, respectively [34][35][36][37][38][39][40] . There are no major differences in the return-to-work rate between surgical and conservative treatment.…”

Section: What Percentage Of Patients Can Return To Work After Treatment?mentioning

confidence: 99%

The Essence of Clinical Practice Guidelines for Lumbar Disc Herniation, 2021: 5. Prognosis

Toyoda

2022

Spine Surg Relat Res

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The impact of psychiatric comorbidity on the return to work in patients undergoing herniated disc surgery

Cited by 6 publications

References 0 publications

An analysis from the Quality Outcomes Database, Part 2. Predictive model for return to work after elective surgery for lumbar degenerative disease

An analysis from the Quality Outcomes Database, Part 2. Predictive model for return to work after elective surgery for lumbar degenerative disease

Identification of Relevant ICF Categories in Vocational Rehabilitation: A Cross Sectional Study Evaluating the Clinical Perspective

The Essence of Clinical Practice Guidelines for Lumbar Disc Herniation, 2021: 5. Prognosis

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