The Impact of the Preoperative Mental Health Component Summary (MCS) Score on Short-Term Outcomes After Lumbar Fusion.

IF 2.6 2区医学 Q2 CLINICAL NEUROLOGY Spine Pub Date : 2025-03-01 Epub Date: 2024-06-07 DOI:10.1097/BRS.0000000000005064

Teeto Ezeonu, Rajkishen Narayanan, Jeremy C Heard, Yunsoo A Lee, Aditya Mazmudar, Jeffrey Zucker, Alexander Shaer, Yoni Dulitzki, Dylan Resnick, Jose A Canseco, Mark F Kurd, Ian D Kaye, Alan S Hilibrand, Alexander R Vaccaro, Christopher Kepler, Gregory D Schroeder

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Abstract

Study design: Retrospective cohort study.

Objective: The purpose of this study is to characterize the relationship between preoperative MCS and surgical outcomes after lumbar spine surgery including inpatient complications, length of stay, readmissions, and reoperations.

Summary of background data: As the prevalence of mental health disorders in the United States increases, it is important to identify risks associated with poor mental health status in the surgical spine patient. The mental health component summary (MCS) of the Short Form-12 has been used extensively as an indication of a patient's mental health status and psychological well-being.

Patients and methods: Adult patients older than or equal to 18 years who underwent primary one to three level lumbar fusion surgery at our academic medical institution from 2017 to 2021 were retrospectively identified. Preoperative MCS score was used to analyze outcomes in patients based on a cutoff (<45.6). A score >45.6 indicated better preoperative mental health and a score ≤45.6 indicated worse preoperative mental health.

Results: Patients with lower preoperative MCS scores had longer hospital stays (3.86±2.16 vs. 3.55±1.42 d, P =0.010) and were more likely to have inpatient renal complications (3.09% vs. 7.19%, P =0.006). Patients with lower preoperative MCS scores also had lower activity measure for post-acute care (AM-PAC) scores (17.1±2.85 vs. 17.6±2.49, P =0.030). Ninety-day surgical readmissions, medical readmissions, and reoperations were not significantly different between groups ( P >0.05).

Conclusion: Our study suggests that patients with lower preoperative mental health scores (MCS ≤45.6) were independently more likely to experience more renal complications and longer length of stay after primary lumbar fusion. In addition, higher MCS scores may correlate with better postoperative mobility and daily activity scores. Nevertheless, long-term outcomes are not significantly different between patients of better or worse preoperative mental health.

Level of evidence: Level IV.

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腰椎融合术后术前心理健康成分总结 (MCS) 评分对短期疗效的影响。

研究设计回顾性队列研究：本研究的目的是描述腰椎手术后术前 MCS 与手术结果之间的关系，包括住院并发症、住院时间、再入院和再手术：随着美国精神疾病患病率的增加，确定脊柱手术患者精神健康状况不良的相关风险非常重要。短表-12的精神健康部分摘要（MCS）已被广泛用于显示患者的精神健康状况和心理健康状况：回顾性地确定了 2017 年至 2021 年期间在本学术医疗机构接受一级至三级腰椎融合术的年龄大于或等于 18 岁的成人患者。根据分界线（45.6 表示术前心理健康较好，得分结果为 45.6），使用术前 MCS 评分分析患者的预后：术前 MCS 评分较低的患者住院时间较长（3.86 + 2.16 天 vs. 3.55 + 1.42 天，P=0.010），更有可能出现住院肾脏并发症（3.09% vs. 7.19%，P=0.006）。术前MCS评分较低的患者，其术后护理活动量（AM-PAC）评分也较低（17.1 + 2.85 vs. 17.6 + 2.49，P=0.030）。90天手术再入院率、内科再入院率和再次手术率在组间无明显差异（P>0.05）：我们的研究表明，术前心理健康评分较低（MCS < 45.6）的患者在初次腰椎融合术后更有可能出现更多肾脏并发症，住院时间也更长。此外，较高的心理健康评分可能与较好的术后活动能力和日常活动评分相关。尽管如此，术前心理健康状况较好或较差的患者的长期预后并无明显差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Spine 医学-临床神经学

CiteScore

5.90

自引率

6.70%

发文量

361

审稿时长

6.0 months

期刊介绍： Lippincott Williams & Wilkins is a leading international publisher of professional health information for physicians, nurses, specialized clinicians and students. For a complete listing of titles currently published by Lippincott Williams & Wilkins and detailed information about print, online, and other offerings, please visit the LWW Online Store. Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.