• Eur Spine J · Oct 2022

    Review

    Exploring clinically relevant risk profiles in patients undergoing lumbar spinal fusion: a cohort study.

    • JanssenEsther R CERC0000-0003-4631-696XDepartment of Orthopedic Surgery, VieCuri Medical Centre, Tegelseweg 210, 5912BL, Venlo, The Netherlands. estherjanssen@viecuri.nl.Department of Orthopedics and Research School Caphri, Maastricht University Medical C, F G Prestigiacomo, E A P van Leent, van MeeterenN L UNLU0000-0002-3067-4167Top Sector Life Sciences and Health (Health~Holland), The Hague, The Netherlands.Department of Anesthesiology, Erasmus Medical Centre, Rotterdam, The Netherlands.Topcare, Leiden, The Netherlands., and M Hulsbosch.
    • Department of Orthopedic Surgery, VieCuri Medical Centre, Tegelseweg 210, 5912BL, Venlo, The Netherlands. estherjanssen@viecuri.nl.
    • Eur Spine J. 2022 Oct 1; 31 (10): 247324802473-2480.

    PurposeTo explore risk profiles of patients scheduled for lumbar spinal fusion (LSF) and their association with short-term recovery of patient after surgery.MethodsForty-nine patients scheduled for elective 1-3 level LSF between March 2019 and June 2020 were included. Patients underwent a preoperative risk screening, consisting of an anamnesis, questionnaires and physical performance tests. A latent profile analysis (LPA) was used to identify possible risk profiles within this population.ResultsTwo risk profiles could be established: a fit and deconditioned risk profile. A significant between-profile difference was found in smoking status (p = 0.007), RAND36-PCS (p < 0.001), Timed Up and Go (TUG) (p < 0.001), de Morton Morbidity Index (DEMMI) (p < 0.001), finger floor distance (p = 0.050), motor control (p = 0.020) and steep ramp test (p = 0.005). Moreover, the fit risk profile had a significant shorter time to functional recovery (3.65 days versus 4.89 days, p = 0.013) and length of hospital stay (5.06 days versus 6.00 days, p = 0.008) compared to the deconditioned risk profile. No differences in complication rates between both risk profiles could be established. Allocation to a risk profile was associated with the functional recovery rate (p = 0.042), but not with LOS or complications.ConclusionThis study found a fit and deconditioned risk profile. The patients with a fit risk profile perceived a better quality of life, performed better in mobility, motor control, cardiopulmonary tests and showed also a significant shorter stay in the hospital and a shorter time to functional recovery. Preoperatively establishing a patient's risk profile could aid in perioperative care planning and preoperative decision-making.© 2022. The Author(s).

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