Back to Search
Start Over
Workers' Compensation Status in Association with a High NDI Score Negatively Impacts Post-Operative Dysphagia and Dysphonia Following Anterior Cervical Fusion.
- Source :
-
World neurosurgery [World Neurosurg] 2021 Oct; Vol. 154, pp. e39-e45. Date of Electronic Publication: 2021 Jul 07. - Publication Year :
- 2021
-
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.<br />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.<br />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).<br />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.<br /> (Copyright © 2021. Published by Elsevier Inc.)
- Subjects :
- Adult
Aged
Clinical Decision-Making
Databases, Factual
Disability Evaluation
Diskectomy
Female
Humans
Insurance Coverage
Male
Middle Aged
Predictive Value of Tests
Propensity Score
Prospective Studies
Risk Factors
Cervical Vertebrae surgery
Deglutition Disorders epidemiology
Deglutition Disorders etiology
Dysphonia etiology
Postoperative Complications epidemiology
Spinal Fusion adverse effects
Workers' Compensation statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1878-8769
- Volume :
- 154
- Database :
- MEDLINE
- Journal :
- World neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 34242831
- Full Text :
- https://doi.org/10.1016/j.wneu.2021.06.100