Details:

Alternative Title:
Spine (Phila Pa 1976)
Publisher's site:
http://dx.doi.org/10.1097/BRS.0b013e3182814ed5
Personal Author:
Keeney, Benjamin J. ; Fulton-Kehoe, Deborah ; Turner, Judith A. ; Wickizer, Thomas M. ; Chan, Kwun Chuen Gary ; ... More +
Keeney, Benjamin J. ; Fulton-Kehoe, Deborah ; Turner, Judith A. ; Wickizer, Thomas M. ; Chan, Kwun Chuen Gary ; Franklin, Gary M. ; Less -
Description:
Study Design Prospective population-based cohort study Objective To identify early predictors of lumbar spine surgery within 3 years after occupational back injury Summary of Background Data Back injuries are the most prevalent occupational injury in the United States. Little is known about predictors of lumbar spine surgery following occupational back injury. Methods Using Disability Risk Identification Study Cohort (D-RISC) data, we examined the early predictors of lumbar spine surgery within 3 years among Washington State workers with new worker’s compensation temporary total disability claims for back injuries. Baseline measures included worker-reported measures obtained approximately 3 weeks after claim submission. We used medical bill data to determine whether participants underwent surgery, covered by the claim, within 3 years. Baseline predictors (P < 0.10) of surgery in bivariate analyses were included in a multivariate logistic regression model predicting lumbar spine surgery. The model’s area under the receiver operating characteristic curve (AUC) was used to determine the model’s ability to identify correctly workers who underwent surgery. Results In the D-RISC sample of 1,885 workers, 174 (9.2%) had a lumbar spine surgery within 3 years. Baseline variables associated with surgery (P < 0.05) in the multivariate model included higher Roland Disability Questionnaire scores, greater injury severity, and surgeon as first provider seen for the injury. Reduced odds of surgery were observed for those under age 35, women, Hispanics, and those whose first provider was a chiropractor. 42.7% of workers who first saw a surgeon had surgery, in contrast to only 1.5% of those who saw a chiropractor. The multivariate model’s AUC was 0.93 (95% CI 0.92–0.95), indicating excellent ability to discriminate between workers who would versus would not have surgery. Conclusion Baseline variables in multiple domains predicted lumbar spine surgery. There was a very strong association between surgery and first provider seen for the injury, even after adjustment for other important variables.
Subject:
[+]
Adult
Article
Back Injuries
Back Injury
Back Pain
Disability Evaluation
Early Diagnosis
Female
Humans
Logistic Models
Lumbar Spine Surgery
Lumbar Vertebrae
Male
Middle Aged
Multivariate Analysis
Occupational Injuries
Outcome Assessment (Health Care)
Predictors
Prognosis
Prospective Studies
Prospective Study
ROC Curve
Surveys And Questionnaires
Time Factors
Washington
Workers' Compensation
Worker’s Compensation

Source:
Spine (Phila Pa 1976). 38(11):953-964 ;
Pubmed ID:
23238486
Pubmed Central ID:
PMC4258106
Document Type:
Journal Article ;
Funding:
R01 OH004069/OH/NIOSH CDC HHS/United States ; T32 AR049710/AR/NIAMS NIH HHS/United States ; R01-OH04069/OH/NIOSH CDC HHS/United States ;
R01 OH004069/OH/NIOSH CDC HHS/United States ; T32 AR049710/AR/NIAMS NIH HHS/United States ; R01-OH04069/OH/NIOSH CDC HHS/United States ; Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:bd76714eff1256d8105b5676e5e030845ddbef87d16e5f71ba00f916fea4c092
File Type:

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