Workers' Compensation Status in Association with a High NDI Score Negatively Impacts Post-Operative Dysphagia and Dysphonia Following Anterior Cervical Fusion.
World Neurosurg
; 154: e39-e45, 2021 10.
Article
en En
| MEDLINE
| ID: mdl-34242831
ABSTRACT
BACKGROUND:
Anterior cervical discectomy and fusion (ACDF) is a safe and effective procedure but has approach-related complications like postoperative dysphagia and dysphonia (PDD). Patient-reported outcome measures including the Hospital for Special Surgery Dysphagia and Dysphonia Inventory (HSS-DDI) have been used for the assessment of PDD. Various factors have been described that affect ACDF outcomes, and our aim was to investigate the effect of workers' compensation (WC) status.METHODS:
We included patients who underwent ACDF from 2015 to 2018 stratified according to insurance status WC/non-WC. PDDs were assessed using the HSS-DDI score. We conducted logistic regression analyses. Statistical significance was set at P < 0.05.RESULTS:
We included 287 patients, 44 (15.33%) WC and 243 (84.67%) non-WC. A statistical comparison revealed a clinically relevant difference in the HSS-DDI total score and both subdomains (P = 0.015; dysphagia P = 0.021; dysphonia P = 0.002). Additional logistic regression analysis adjusting for preoperative Neck Disability Index scores resulted in no clinically relevant differences in the HSS-DDI total score and both subdomains (total score P = 0.420; dysphagia P = 0.531; dysphonia 0.315).CONCLUSIONS:
WC status was associated with a worse HSS-DDI score but could not be shown to be an independent risk factor for PDD. The preoperative NDI score was a strong predictor for PDD with a clinically relevant difference in the HSS DDI score (P < 0.0001). Surgeon awareness of risk factors for PDD such as WC status, even if it could not be shown as independent, is important as it may influence surgical decision making and managing patient expectations.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
/
Fusión Vertebral
/
Trastornos de Deglución
/
Vértebras Cervicales
/
Indemnización para Trabajadores
/
Disfonía
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
World Neurosurg
Asunto de la revista:
NEUROCIRURGIA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos