Grob Mannion
Fakultäten » Medizinische Fakultät » Rheumaklinik und Institut für physikalische Medizin » PD Dr. Anne Mannion » Grob Mannion
Completed research project
| Title / Titel | Patient-rated complications after spinal surgery: incidence and bothersomeness | ||||
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| Abstract (PDF, 14 KB) | |||||
| Summary / Zusammenfassung | INTRODUCTION It is generally accepted that the patient should be the main judge of outcome after spinal surgery, using self-ratings of pain, function, and quality-of-life. Recently, the assessment of complications after surgery was investigated using a similar patient-orientated approach and yielded 4-5-fold the typical complication-rates reported by surgeons themselves. However, the severity of these complications was not assessed, and it was unclear whether they impacted notably on the patient’s life. The present study examined the perceived severity of patient-rated postoperative complications. METHODS All German-speaking lumbar spine patients operated on within our Center from 1.9.2006–31.8.2007 were asked to complete a questionnaire 12 months post-op (global outcome and satisfaction with treatment of back problem). Patients were also asked: “did any complications arise as a consequence of your operation 1 year ago (e.g. problems with wound healing, paralysis, sensory disturbances, etc.)? If so, give details.” They rated the bothersomeness of any such complications on a 5-point adjectival scale. RESULTS 863 (91%) patients returned the questionnaire. 31% patients reported complications. Sensory disturbances were most common (38% of all complications), followed by pain (22%), pain and sensory disturbances (11%), motor problems (8%), and wound healing (6%). The distribution of the complications’ “bothersomeness” was: 2% not at all, 19% slightly, 27% moderately, 35% very, and 17% extremely bothersome. Bothersomeness showed a significant correlation with global outcome (Rho=0.51,p<0.0001) and satisfaction (Rho=0.41,p<0.0001). DISCUSSION The majority of complications reported by the patient are perceived to be moderately to extremely bothersome, and they impact on the global outcome rating and satisfaction of the patient. Hence they are not just inconsequential findings. Just like outcome, “complications” and their severity should be assessed from both the patient’s and the surgeon’s perspectives. Surgeons’ complication-rates are typically much lower than 31%; the reasons for the discrepancy with the patients’ perceptio | ||||
| Publications / Publikationen | 1) Grob D, Mannion AF, Bartanusz V, Kleinstueck F, Lattig F, Jeszenszky D, Dvorak J and Porchet F (2007) Complications after spinal surgery: the patient’s perspective. ISSLS, Hong Kong, 10-14.6.2007. 2) Grob D, Lattig F, Kleinstueck F, Jeszenszky D and Mannion AF (2007) The patient's view of "complications" after deformity surgery: the potential of surgical registries. 14th International Meeting on Advanced Spine Techniques (IMAST), Paradise Island, Bahamas, 11-14.7.2007. 3) Grob D, Mannion AF, Lattig F, Kleinstueck F, Bartanusz V, Jeszenszky D, Porchet F (2007) Patient-rated "complications" after cervical spine surgery: a prospective study within the framework of the SSE Spine Tango Spine Surgery Registry. European section of the Cervical Spine Research Society. Leuven, Belgium 16 (Suppl 1):S50 4) Grob D, Kleinstück Fr, Bartanusz V, Lattig F, Jeszenszky D, Dvorak J, Porchet F, Mannion AF (2008) The patient’s perspective on complications after spine surgery. Schweizerische Gesellschaft für Orthopädie. Basel, Switzerland, 24-26-9.2008. Swiss Medical Forum 8 (Suppl 44):S22 5) Grob D, Kleinstück F, Lattig F, Porchet F, Jeszenszky D, Mannion AF. The bothersomeness of patient-rated complications after lumbar spine surgery. International Society for the Study of the Lumbar Spine. Florida, USA, 4-8.5.2009 6) Grob D, Mannion AF (2009) The patient's perspective on complications after spine surgery. Eur Spine J 18 (Suppl 3): 380-5 7) Mannion AF, Fekete T, Kleinstueck FS, Mutter U, Lattig F, Porchet F, Jeszenszky D and Grob D. The bothersomeness of patient self-rated complications after spine surgery. Society for Back Pain Research, Cambridge, UK, 09-10.11.2011 |
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| Keywords / Suchbegriffe | patient-rated outcome, patient-rated complications, spine surgery | ||||
| Project leadership and contacts / Projektleitung und Kontakte |
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| Funding source(s) / Unterstützt durch |
Foundation Stiftung Wilhelm Schulthess Forschungsfonds |
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| Duration of Project / Projektdauer | May 2006 to Dec 2009 |