Abstract：
Low early postoperative mobility (LEPOM) has been shown to be associated with increased length of hospital stay, complication rates, and likelihood of nonhome discharge. However, few studies have examined preoperative characteristics associated with LEPOM in adult spinal deformity (ASD) patients.
To investigate which preoperative patient characteristics may be associated with LEPOM after ASD surgery.
Retrospective review.
Included were 86 ASD patients with fusion of ≥5 levels for whom immediate-postoperative AM-PAC Basic Mobility Inpatient Short Form (6-Clicks) scores had been obtained.
The primary outcome of this study was the likelihood of LEPOM, defined as an AM-PAC score ≤15, which is associated with inability to stand for more than 1 minute.
Significant cutoffs for preoperative characteristics associated with LEPOM were determined via threshold linear regression. Multivariable logistic regression was used to assess the impact of preoperative characteristics on the likelihood of LEPOM.
LEPOM was recorded in 38 patients (44.2%). Threshold regression identified the following cutoffs to be associated with LEPOM: preoperative Patient Reported Outcomes Measurement Information System (PROMIS) scores of ≥68 for Pain, <28.3 for Physical Function, and ≥63.4 for Anxiety; preoperative Oswestry disability index (ODI) score of ≥60; and body mass index (BMI) of ≥35.2. On multivariate analysis, preoperative PROMIS scores of ≥68 for Pain (odds ratio [OR] 5.3, confidence interval [CI] 1.2-22.8, p=.03), <28.3 for Physical Function (OR 10.1, CI 1.8-58.2, p=.01), and ≥63.4 for Anxiety (OR 4.7, CI 1.1-20.8, p=.04); preoperative ODI score ≥60 (OR 38.8, CI 4.0-373.6, p=.002); BMI ≥35.2 (OR 14.2, CI 1.3-160.0, p=.03), and male sex (OR 5.4, CI 1.2-23.7, p=.03) were associated with increased odds of LEPOM.
Preoperative PROMIS Pain, Physical Function, and Anxiety scores; ODI score; BMI; and male sex were associated with LEPOM. Several of these characteristics are modifiable risk factors and thus may be candidates for optimization before surgery.
III.
To investigate which preoperative patient characteristics may be associated with LEPOM after ASD surgery.
Retrospective review.
Included were 86 ASD patients with fusion of ≥5 levels for whom immediate-postoperative AM-PAC Basic Mobility Inpatient Short Form (6-Clicks) scores had been obtained.
The primary outcome of this study was the likelihood of LEPOM, defined as an AM-PAC score ≤15, which is associated with inability to stand for more than 1 minute.
Significant cutoffs for preoperative characteristics associated with LEPOM were determined via threshold linear regression. Multivariable logistic regression was used to assess the impact of preoperative characteristics on the likelihood of LEPOM.
LEPOM was recorded in 38 patients (44.2%). Threshold regression identified the following cutoffs to be associated with LEPOM: preoperative Patient Reported Outcomes Measurement Information System (PROMIS) scores of ≥68 for Pain, <28.3 for Physical Function, and ≥63.4 for Anxiety; preoperative Oswestry disability index (ODI) score of ≥60; and body mass index (BMI) of ≥35.2. On multivariate analysis, preoperative PROMIS scores of ≥68 for Pain (odds ratio [OR] 5.3, confidence interval [CI] 1.2-22.8, p=.03), <28.3 for Physical Function (OR 10.1, CI 1.8-58.2, p=.01), and ≥63.4 for Anxiety (OR 4.7, CI 1.1-20.8, p=.04); preoperative ODI score ≥60 (OR 38.8, CI 4.0-373.6, p=.002); BMI ≥35.2 (OR 14.2, CI 1.3-160.0, p=.03), and male sex (OR 5.4, CI 1.2-23.7, p=.03) were associated with increased odds of LEPOM.
Preoperative PROMIS Pain, Physical Function, and Anxiety scores; ODI score; BMI; and male sex were associated with LEPOM. Several of these characteristics are modifiable risk factors and thus may be candidates for optimization before surgery.
III.
摘要：
背景：术后早期活动度低（LEPOM）已被证明与住院时间增加有关，并发症发生率,以及非家庭出院的可能性。然而,很少有研究在成人脊柱畸形(ASD)患者中检查与LEPOM相关的术前特征.
目的：探讨ASD手术后哪些患者的术前特征可能与LEPOM相关。
方法：回顾性回顾患者样本：包括86例ASD患者，其融合水平≥5级，术后即刻获得AM-PAC基本流动性住院患者简短形式（6次点击）评分。
方法：这项研究的主要结果是LEPOM的可能性，定义为AM-PAC评分≤15，这与无法站立超过1分钟有关。
方法：通过阈值线性回归确定与LEPOM相关的术前特征的显著截止值。多变量逻辑回归用于评估术前特征对LEPOM可能性的影响。
结果：在38例患者中记录了LEPOM（44.2%）。阈值回归确定了以下与LEPOM相关的截止值：术前患者报告的结果测量信息系统（PROMIS）疼痛评分≥68，<28.3对于身体功能，焦虑≥63.4；术前Oswestry残疾指数（ODI）评分≥60；体重指数（BMI）≥35.2。在多变量分析中，术前疼痛的PROMIS评分≥68分（比值比[OR]5.3，置信区间[CI]1.2-22.8，P=0.03），物理功能<28.3（OR10.1，CI1.8-58.2，P=0.01），焦虑≥63.4（OR4.7，CI1.1-20.8，P=.04）；术前ODI评分≥60（OR38.8，CI4.0-373.6，P=.002）；BMI≥35.2（OR14.2，CI1.3-160.0，P=0.03），男性（OR5.4，CI1.2-23.7，P=0.03）与LEPOM的几率增加相关。
结论：术前PROMIS疼痛，身体功能,焦虑评分、ODI评分、BMI和男性与LEPOM相关。这些特征中的一些是可改变的风险因素,因此可以是在手术前进行优化的候选。
目的：探讨ASD手术后哪些患者的术前特征可能与LEPOM相关。
方法：回顾性回顾患者样本：包括86例ASD患者，其融合水平≥5级，术后即刻获得AM-PAC基本流动性住院患者简短形式（6次点击）评分。
方法：这项研究的主要结果是LEPOM的可能性，定义为AM-PAC评分≤15，这与无法站立超过1分钟有关。
方法：通过阈值线性回归确定与LEPOM相关的术前特征的显著截止值。多变量逻辑回归用于评估术前特征对LEPOM可能性的影响。
结果：在38例患者中记录了LEPOM（44.2%）。阈值回归确定了以下与LEPOM相关的截止值：术前患者报告的结果测量信息系统（PROMIS）疼痛评分≥68，<28.3对于身体功能，焦虑≥63.4；术前Oswestry残疾指数（ODI）评分≥60；体重指数（BMI）≥35.2。在多变量分析中，术前疼痛的PROMIS评分≥68分（比值比[OR]5.3，置信区间[CI]1.2-22.8，P=0.03），物理功能<28.3（OR10.1，CI1.8-58.2，P=0.01），焦虑≥63.4（OR4.7，CI1.1-20.8，P=.04）；术前ODI评分≥60（OR38.8，CI4.0-373.6，P=.002）；BMI≥35.2（OR14.2，CI1.3-160.0，P=0.03），男性（OR5.4，CI1.2-23.7，P=0.03）与LEPOM的几率增加相关。
结论：术前PROMIS疼痛，身体功能,焦虑评分、ODI评分、BMI和男性与LEPOM相关。这些特征中的一些是可改变的风险因素,因此可以是在手术前进行优化的候选。
