title: Factors Predicting Patient Dissatisfaction 2 Years After Discectomy for Lumbar Disc Herniation in a Chinese Older Cohort: A Prospective Study of 843 Cases at a Single Institution.
abstract: We aim to identify factors predicting patient dissatisfaction 2 years after discectomy for lumbar disc herniation (LDH) in a Chinese older cohort. Preoperative and 2-year follow-up data for 843 patients were analyzed. After 2 years of discectomy, the patients rated their satisfaction by Patient Satisfaction Index (PSI), with response of 1 or 2 defining satisfaction and a PSI response of 3 or 4 defining dissatisfaction. Associations between perioperative variables and satisfaction with the results of surgery were examined in univariate and multivariate analysis. Six hundred fifty-seven patients had a PSI of 1 or 2 and were enrolled as satisfied group, 186 patients had a PSI of 3 or 4 and were enrolled as dissatisfied group. At baseline, no significant differences were found between the 2 groups in age, occupation, Oswestry Disability Index (ODI), Visual Analog Scale (VAS)-leg, and VAS-back. Compared to satisfied group, dissatisfied group had a significantly higher BMI and a higher incidence of depression. Two years after discectomy, no significant differences were found between the 2 groups in decrease of ODI, decrease of VAS-back, decrease of VAS-leg, surgery complications. Compared to satisfied group, dissatisfied group experienced higher incidence of symptom recurrence and depression. Logistic regression analysis showed that obesity, pre- and postoperative depression, symptom recurrence were independently associated with patient dissatisfaction 2 years after discectomy.I n conclusion, more than 70% patients expressed satisfaction with discectomy for LDH. Two factors could predict patient dissatisfaction and be assessed before surgery: obesity and preoperative depression. Symptom recurrence and postoperative depression are also associated with diminished patient satisfaction.
authors.affiliation: From the Department of Spine Surgery, The Third Hospital of HeBei Medical University, Shijiazhuang, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.forename: Di
authors.initials: D
authors.lastname: Zhang
authors.forename: Lei
authors.initials: L
authors.lastname: Ma
authors.forename: Yong
authors.initials: Y
authors.lastname: Shen
authors.forename: Wenyuan
authors.initials: W
authors.lastname: Ding
mesh_terms: D044466:Asian People; D015992:Body Mass Index; D003863:Depression / Q000150:complications; D017586:Diskectomy; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008875:Middle Aged; D015999:Multivariate Analysis; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome