264594 Predictors of back surgery after occupational back injury

Wednesday, October 31, 2012 : 8:30 AM - 8:50 AM

Benjamin Keeney, PhD , Orthopaedics, Geisel School of Medicine, Dartmouth College, Lebanon, NH
Deborah Fulton-Kehoe, PhD, MPH , Environmental and Occupational Health Sciences, University of Washington, Seattle, WA
Judith A. Turner, PhD , Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
Thomas Wickizer, PhD , Division of Health Services Management and Policy, The Ohio State University, Columbus, OH
K.C. Gary Chan, PhD , Department of Biostatistics, University of Washington, Seattle, WA
Gary M. Franklin, MD, MPH , Environmental and Occupational Health Sciences, University of Washington, Seattle, WA
Occupational back injuries are the most prevalent and costly occupational injury in the United States. Little is known about predictors of back surgery following an occupational back injury. We aimed to identify early predictors of back surgery within 3 years of filing a claim for a back injury. The Washington Workers' Compensation Disability Risk Identification Study Cohort (D-RISC) provided a population-based sample of workers with work loss due to recent back injuries, with information from administrative databases and worker interviews approximately 3 weeks after back injury on variables in eight domains, including sociodemographic, employment-related, pain and function, clinical status, health care, administrative/legal, health behavior, and psychological. We first identified baseline factors associated with (P < 0.10) surgery in bivariate analyses, then entered these in a multivariate logistic regression model predicting surgery (P < 0.05). 174 (9.2%) of 1,885 workers with recent back injuries had a back surgery within 3 years. Early predictors included suburban residence, not returning to work by the interview, more pain sites, higher Roland Disability Questionnaire scores, and greater injury severity. Workers under age 24, women, minorities, tobacco users, and those who first saw a chiropractor for their injury had lower odds of surgery. Early predictors of back surgery included variables from six domains. This information may be useful for matching patients in future comparative effectiveness studies of back surgery versus alternative treatments for occupational back pain and injury.

Learning Areas:
Occupational health and safety
Provision of health care to the public
Public health or related research

Learning Objectives:
Identify predictors for back surgery within 3 years of filing a claim for a back injury.

Keywords: Occupational Injury and Death, Workers' Compensation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: My scientific interests have focused on occupational back injuries for several years, including my dissertation work.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5081.0: Occupational Injury Research