Patient Demographic and Surgical Factors that Affect Completion of Patient-Reported Outcomes 90 Days and 1 Year After Spine Surgery: Analysis from the Michigan Spine Surgery Improvement Collaborative (MSSIC)

World Neurosurg. 2019 Oct;130:e259-e271. doi: 10.1016/j.wneu.2019.06.058. Epub 2019 Jun 15.


Background: The Michigan Spine Surgery Improvement Collaborative is a statewide multicenter quality improvement registry. Because missing data can affect registry results, we used MSSIC to find demographic and surgical characteristics that affect the completion of patient-reported outcomes (PROs) at 90 days and 1 year.

Methods: A total of 24,404 patients who had lumbar surgery (17,813 patients) or cervical surgery (6591 patients) were included. Multivariate logistic regression models of patient disease were constructed to identify risk factors for failure to complete scheduled PRO surveys.

Results: Patients ≥65 years old and female patients were both more likely to respond at 90 days and 1 year. Increasing education was associated with greater response rate at 90 days and 1 year. Whites and African Americans had no differences in response rates. Calling provided the highest response rate at 90 days and 1 year. For cervical spine patients, only discharge to rehabilitation increased completion rates, at 90 days but not 1 year. For lumbar spine patients, spondylolisthesis or stenosis (vs. herniated disc) had a greater response rate at 1 year. Patients with leg (vs. back) pain had a greater response only at 1 year. Patients with multilevel surgery had an increased response at 1 year. Patients who underwent fusion were more likely to respond at 90 days, but not 1 year. Discharge to rehabilitation increased response at 90 days and 1 year.

Conclusions: A multivariate analysis from a multicenter prospective database identified surgical factors that affect PRO follow-up, up to 1 year. This information can be helpful for imputing missing PRO data and could be used to strengthen data derived from large prospective databases.

Keywords: Demographics; Lumbar spine surgery; Patient-reported outcomes; Prospective study; Quality improvement; Spondylolisthesis; Spondylosis.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cervical Vertebrae / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Lumbar Vertebrae / surgery*
  • Male
  • Michigan
  • Middle Aged
  • Neurosurgical Procedures / trends*
  • Patient Reported Outcome Measures*
  • Prospective Studies
  • Spinal Diseases / diagnosis
  • Spinal Diseases / epidemiology
  • Spinal Diseases / surgery*
  • Time Factors