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Objective <p>To examine sociodemographic, clinical, and healthcare-related factors associated with preoperative health-related quality of life (HRQoL) among patients undergoing surgery for degenerative lumbar spine conditions in a multi-ethnic Asian population.</p> Methods <p>This cross-sectional study used baseline data from the Spine PROM Surgery Registry, including 1194 patients scheduled for surgery within a Singapore healthcare cluster between 2017 and 2022. HRQoL was measured using the EQ-5D-3L, with utility scores crosswalked to the EQ-5D-5L index using the van Hout crosswalk. Hierarchical linear regression assessed factors associated with HRQoL across three blocks: sociodemographic, clinical, and healthcare/lifestyle. Multivariable logistic regression identified factors associated with reporting problems within each EQ-5D dimension.</p> Results <p>Mean age was 58.1 years (SD 16.1); 51.5% were male. Mean EQ-5D-5L crosswalk index was 0.43 (SD 0.38). Pain/discomfort (93.6%) and usual activities problems (84.3%) were most commonly reported. Lower EQ-5D scores were independently associated with non-outpatient presentation (β = −0.37), non-Chinese ethnicity, primary education or below relative to higher levels, and history of accident or trauma (β = −0.11). Dimension-level analyses showed primary education or below was associated with higher odds of problems across mobility, self-care, usual activities, and anxiety/depression compared with higher education levels, with a clear monotonic gradient. Female sex was associated with higher odds of pain/discomfort and anxiety/depression problems compared with male sex. Non-outpatient presentation was associated with markedly higher odds of self-care problems (OR = 2.98).</p> Conclusions <p>Patients awaiting lumbar spine surgery appear to have impaired preoperative HRQoL. Although the modest explained variance limits robust risk prediction, preoperative profiles may still help inform clinical discussions and shared decision-making. Non-outpatient presentation may help identify patients who could benefit from enhanced preoperative support, although this requires prospective validation. Differences by ethnicity and education suggest opportunities for culturally tailored counselling. EQ-5D dimension profiles may indicate targets for prehabilitation and provide Singapore-based benchmark data for a lumbar spine surgery cohort for patient-centred care, service benchmarking, and health technology assessment.</p>

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Factors associated with preoperative health-related quality of life in patients undergoing lumbar spine surgery: a multi-ethnic Asian cohort

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月3日

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  • Xun Li,
  • Calvin Wei Jie Chern,
  • Alex Quok An Teo,
  • Jiong Hao Jonathan Tan,
  • Annushiah Vasan Thakumar,
  • Nan Luo,
  • Hwee Weng Dennis Hey,
  • Ling Jie Cheng

摘要

Objective

To examine sociodemographic, clinical, and healthcare-related factors associated with preoperative health-related quality of life (HRQoL) among patients undergoing surgery for degenerative lumbar spine conditions in a multi-ethnic Asian population.

Methods

This cross-sectional study used baseline data from the Spine PROM Surgery Registry, including 1194 patients scheduled for surgery within a Singapore healthcare cluster between 2017 and 2022. HRQoL was measured using the EQ-5D-3L, with utility scores crosswalked to the EQ-5D-5L index using the van Hout crosswalk. Hierarchical linear regression assessed factors associated with HRQoL across three blocks: sociodemographic, clinical, and healthcare/lifestyle. Multivariable logistic regression identified factors associated with reporting problems within each EQ-5D dimension.

Results

Mean age was 58.1 years (SD 16.1); 51.5% were male. Mean EQ-5D-5L crosswalk index was 0.43 (SD 0.38). Pain/discomfort (93.6%) and usual activities problems (84.3%) were most commonly reported. Lower EQ-5D scores were independently associated with non-outpatient presentation (β = −0.37), non-Chinese ethnicity, primary education or below relative to higher levels, and history of accident or trauma (β = −0.11). Dimension-level analyses showed primary education or below was associated with higher odds of problems across mobility, self-care, usual activities, and anxiety/depression compared with higher education levels, with a clear monotonic gradient. Female sex was associated with higher odds of pain/discomfort and anxiety/depression problems compared with male sex. Non-outpatient presentation was associated with markedly higher odds of self-care problems (OR = 2.98).

Conclusions

Patients awaiting lumbar spine surgery appear to have impaired preoperative HRQoL. Although the modest explained variance limits robust risk prediction, preoperative profiles may still help inform clinical discussions and shared decision-making. Non-outpatient presentation may help identify patients who could benefit from enhanced preoperative support, although this requires prospective validation. Differences by ethnicity and education suggest opportunities for culturally tailored counselling. EQ-5D dimension profiles may indicate targets for prehabilitation and provide Singapore-based benchmark data for a lumbar spine surgery cohort for patient-centred care, service benchmarking, and health technology assessment.