Pre-operative patient education does not necessarily reduce length of stay or pain after spinal surgery

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Interdisciplinary Neurosurgery


Background Previous research has shown pre-operative education may have a beneficial impact on postoperative recovery for elective surgery including: reduced length of hospital stay, improved post-operative pain management, and improved patient satisfaction.

Objective We conducted a retrospective study to elucidate the impact of pre-operative education on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores, postoperative pain, and length of stay (LOS) following spinal surgery.

Methods A retrospective matched case control study was conducted between patients who participated in pre-operative education (n = 113) and those who did not (n = 116). Univariate analysis through a Two-Samples Independent T-Test was conducted for postoperative pain and LOS. Multivariate analysis for LOS was evaluated using Poisson Generalized Estimating Equation (GEE) Standard Errors regression while pain multivariate analysis was conducted using a linear GEE regression model. HCAHPS univariate and multivariate analyses were also performed.

Results Univariate analysis showed no statistically significant difference with LOS (3.58 days vs. 3.63 days, p = 0.85) and post-operative pain (4.65 vs. 4.59, p = 0.80). Multivariate analysis of HCAHPS metrics revealed patients who attended the preoperative education class reported statistically significant lower “how well your pain was controlled” responses (−36p = 0.024) as well as “staff effort in including the patient in treatment decisions” responses (−37p = 0.046).

Conclusions According to our data preoperative education prior to spinal surgery does not necessarily result in improved pain management, shorter length of stay, or higher patient satisfaction. Prospective research may help determine the proper measures that can improve the likelihood of achieving the intended results.



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