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Younger age may be a predictor of loss to long-term follow-up

Issue: December 2014

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SAN FRANCISCO — Among patients who undergo elective spine surgery for degenerative spine disease, the patients who are lost to long-term follow-up are not those with worse outcomes or increased dissatisfaction, according to results of a study presented here.

“The only independent predictor of loss to follow-up in the degenerative spine population is younger age, as people return to work and it hinders tracking of long-term data,” Scott L. Parker, MD, said at the North American Spine Society Annual Meeting.

Scott L. Parker

In a prospective, comparison cohort study, Parker and colleagues aimed to determine whether there was an association between patient demographics and outcomes vs. a loss to follow-up 12 months after spine surgery. Overall, 1,484 patients who underwent elective spine surgery for degenerative spine disease at Vanderbilt University Medical Center during a 2-year period were enrolled in a prospective longitudinal registry. All patients had baseline 3-month outcomes.

Outcome measures included Numeric Rating Scale, Oswestry Disability Index, Neck Disability Index, SF-12, Zung Depression Scale, Modified Somatic Perception Questionnaire, EuroQol-5D, morbidity, complications and 12-month follow-up status.

The researchers found the 12-month loss-to-follow-up rate was approximately 15%. Patients lost to follow-up were younger at 51 years, compared with 57.1 years for patients not lost to follow-up. Additionally, a higher proportion of lost-to-follow-up patients were employed before surgery.

Patients in both groups had similar preoperative pain, disability and quality of life. There was no difference between the groups in terms of 90-day morbidity, 3-month pain, disability, quality of life or patient satisfaction, according to Parker.

Parker said loss to follow-up does not introduce any biases in study results and is not associated with poorer outcomes and patient dissatisfaction. Future studies will target the younger population to see if different data acquisition systems, such as email or apps, improve compliance. — by Kristine Houck, MA, ELS

Reference:

Parker SL. Paper #52. Presented at: North American Spine Society Annual Meeting. Nov. 12-15, 2014; San Francisco.

Disclosure: Parker has no relevant financial disclosures.