Frequent users of health-care services have worse outcomes of spinal surgery: Results from a web-based survey

Background and Objective: Spinal surgery becomes ever safer and the success rate is constantly increasing. Nevertheless many patients present poor outcomes despite apparent technical success. Proper selection of patients is key, but it is virtually impossible to provide a clear algorithm as there are great many aspects to be considered. The purpose of this study was to assess the potential of anonymous web surveys as screening tools for factors predicting poor outcomes of surgery. The hypothesis was that frequent users of health-care services (FUOHS) are worse surgical candidates. Methods: An open anonymous and interactive web surveys were placed within a web portal concerning the spinal health. It was comprised of three sections: first one focused on demographics and information regarding the surgery, second being the Core Outcome Measures Index questionnaire, and the third containing additional information. Results: A total of 425 subjects completed the questionnaire. After removing multiple entries, the final number of subjects included in the study was 411. The relative risk of an unfavorable outcome in a FUOHS group was 3.63 compared with the rest. Likewise, the relative risk of reporting complications in this group was 1.94 though it reached the statistical significance only in the subgroup of patients who had a surgery on a lumbar segment. Discussion and Conclusions: The web surveys can help identify factors that can predict bad outcomes of surgical treatment. In this case, it was shown that frequent visits to doctors' office for reasons other than spine-related is a negative prognostic factor for good outcome of spine surgery.