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The Impact of Preoperative Depression on Quality of Life Outcomes Following Lumbar Surgery.

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The Impact of Preoperative Depression on Quality of Life Outcomes Following Lumbar Surgery.

Spine J. 2014 Jul 4;

Authors: Miller J, Derakhshan A, Lubelski D, Alvin MD, McGirt MJ, Benzel EC, Mroz TE

Abstract
BACKGROUND CONTEXT: Other, smaller studies have investigated the effect of preoperative depression upon postoperative improvement in QOL. However, they have not utilized the PHQ-9 questionnaire in self-reported depression.
PURPOSE: To assess the effect of preoperative depression as measured by the PHQ-9 questionnaire upon postoperative improvement in quality of life (QOL).
STUDY DESIGN/SETTING: Retrospective review at a single tertiary-care referral center.
PATIENT SAMPLE: Patients that underwent lumbar decompression or fusion between 2008 and 2012.
OUTCOMES MEASURES: Self-Reported EuroQol 5-Dimensions (EQ-5D) Quality-Adjusted Life-Years Index METHODS: QOL data was collected using the institutional prospectively-collected database of patient-reported health status measures. The EQ-5D, PDQ, and PHQ-9 questionnaires were utilized. Linear and logistic regression analyses were performed to assess the impact of preoperative depression upon QOL improvement. No funding sources nor conflicts of interest were present.
RESULTS: Elevated preoperative pain (PDQ, ? = -0.0017, p = 0.0009) and worsened depression (PHQ-9, ? = -0.0044, p = 0.0359) were significantly associated with a diminished postoperative improvement in QOL, as measured by the EQ-5D. Furthermore, greater depression (PHQ-9, OR 0.93, p < 0.0001) and pain (PDQ, OR 0.99, p = 0.02) were associated with a significantly diminished postoperative improvement exceeding the minimum clinically important difference (MCID).
CONCLUSIONS: Increased preoperative pain and depression were shown to be associated with a significantly reduced improvement in postoperative QOL, as measured by the EQ-5D.

PMID: 25007757 [PubMed – as supplied by publisher]

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