Greater Socioeconomic Disadvantage Is Associated with Worse Symptom Severity at Initial Presentation in Patients Seeking Care for Lumbar Disc Herniation.
Adolescent
Adult
Aged
Aged, 80 and over
Cohort Studies
Female
Humans
Intervertebral Disc Degeneration
/ diagnosis
Intervertebral Disc Displacement
/ diagnosis
Lumbar Vertebrae
/ surgery
Male
Middle Aged
Retrospective Studies
Severity of Illness Index
Socioeconomic Factors
Surveys and Questionnaires
Vulnerable Populations
Young Adult
Journal
Spine
ISSN: 1528-1159
Titre abrégé: Spine (Phila Pa 1976)
Pays: United States
ID NLM: 7610646
Informations de publication
Date de publication:
01 Apr 2021
01 Apr 2021
Historique:
pubmed:
13
11
2020
medline:
13
5
2021
entrez:
12
11
2020
Statut:
ppublish
Résumé
Retrospective, observational study. To determine the association of patient socioeconomic disadvantage, insurance type, and other characteristics on presenting symptom severity in patients with isolated lumbar disc herniation. Little is known of the impact of socioeconomic disadvantage and other patient characteristics on the level of self-reported symptom severity when patients first seek care for lumbar disc herniation. Between April 2015 and December 2018, 734 patients newly presenting for isolated lumbar disc herniation who completed the Patient-Reported Outcomes Measurement Information System Physical Function (PF), Pain Interference (PI), and Depression Computer Adaptive Tests (CATs) were identified. Socioeconomic disadvantage was determined using the Area Deprivation Index, a validated measure of socioeconomic disadvantage at the census block group level (0-100, 100 = highest socioeconomic disadvantage). Bivariate analyses were used. Multivariable linear regression was used to determine if there was an association between socioeconomic disadvantage, insurance type, and other patient factors and presenting patient-reported health status. Significant differences in age, insurance type, self-reported race, marital status, and county of residence were appreciated when comparing patient characteristics by socioeconomic disadvantage levels (all comparisons, P < 0.01). In addition, significant differences in age, insurance type, marital status, and county of residence were appreciated when comparing patient characteristics by self-reported race (all comparisons, P < 0.01). Being in the most socioeconomically disadvantaged cohort was associated with worse presenting Patient-Reported Outcomes Measurement Information System scores (Physical Function: β = -3.27 (95% confidence interval [CI]: -4.89 to -1.45), P < 0.001; Pain Interference: β = 3.20 (95% CI: 1.58-4.83), P < 0.001; Depression: β = 3.31 (95% CI: 1.08-5.55), P = 0.004. The most socioeconomically disadvantaged patients with symptomatic lumbar disc herniations present with worse functional limitations, pain levels, and depressive symptoms as compared to patients from the least socioeconomically disadvantaged cohort when accounting for other key patient factors.Level of Evidence: 3.
Sections du résumé
STUDY DESIGN
METHODS
Retrospective, observational study.
OBJECTIVE
OBJECTIVE
To determine the association of patient socioeconomic disadvantage, insurance type, and other characteristics on presenting symptom severity in patients with isolated lumbar disc herniation.
SUMMARY OF BACKGROUND DATA
BACKGROUND
Little is known of the impact of socioeconomic disadvantage and other patient characteristics on the level of self-reported symptom severity when patients first seek care for lumbar disc herniation.
METHODS
METHODS
Between April 2015 and December 2018, 734 patients newly presenting for isolated lumbar disc herniation who completed the Patient-Reported Outcomes Measurement Information System Physical Function (PF), Pain Interference (PI), and Depression Computer Adaptive Tests (CATs) were identified. Socioeconomic disadvantage was determined using the Area Deprivation Index, a validated measure of socioeconomic disadvantage at the census block group level (0-100, 100 = highest socioeconomic disadvantage). Bivariate analyses were used. Multivariable linear regression was used to determine if there was an association between socioeconomic disadvantage, insurance type, and other patient factors and presenting patient-reported health status.
RESULTS
RESULTS
Significant differences in age, insurance type, self-reported race, marital status, and county of residence were appreciated when comparing patient characteristics by socioeconomic disadvantage levels (all comparisons, P < 0.01). In addition, significant differences in age, insurance type, marital status, and county of residence were appreciated when comparing patient characteristics by self-reported race (all comparisons, P < 0.01). Being in the most socioeconomically disadvantaged cohort was associated with worse presenting Patient-Reported Outcomes Measurement Information System scores (Physical Function: β = -3.27 (95% confidence interval [CI]: -4.89 to -1.45), P < 0.001; Pain Interference: β = 3.20 (95% CI: 1.58-4.83), P < 0.001; Depression: β = 3.31 (95% CI: 1.08-5.55), P = 0.004.
CONCLUSION
CONCLUSIONS
The most socioeconomically disadvantaged patients with symptomatic lumbar disc herniations present with worse functional limitations, pain levels, and depressive symptoms as compared to patients from the least socioeconomically disadvantaged cohort when accounting for other key patient factors.Level of Evidence: 3.
Identifiants
pubmed: 33181773
pii: 00007632-202104010-00014
doi: 10.1097/BRS.0000000000003811
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
464-471Informations de copyright
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
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