ArticleQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation2026
Preoperative health-related quality of life across four degenerative lumbar conditions in a multi-ethnic Southeast Asian surgical cohort: a cross-sectional SF-36 analysis.
Article in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThe evidence base for preoperative health-related quality of life (HRQoL) in degenerative lumbar conditions derives predominantly from Western populations. This study characterised HRQoL across four degenerative lumbar conditions in a multi-ethnic Southeast Asian surgical cohort and identified factors associated with physical and mental health at composite and domain levels.
methodsCross-sectional analysis of 1173 preoperative patients from a Singaporean spine surgery registry (2017-2022). SF-36 norm-based T-scores were computed for eight domains and two component summaries. Diagnosis-stratified stepwise multiple regression identified factors associated with the Physical Component Summary (PCS), Mental Component Summary (MCS), and domain scores. LASSO regression served as a sensitivity analysis.
resultsMean PCS was 35.6 (SD 8.9), 1.4 SD below the US normative mean, whereas MCS was 50.3 (SD 9.7), near normative levels. Physical functioning and role-physical were the most impaired domains. Scores differed across the four diagnoses on six of the ten SF-36 outcomes (one-way ANOVA, all p < 0.05; corroborated by Kruskal-Wallis tests), although effect sizes were small (eta-squared ≤ 0.02). Functional disability showed the strongest association with PCS across all four conditions (β range: - 0.32 to - 0.28; adjusted R
conclusionFunctional disability was most strongly associated with physical HRQoL, channelled through physical functioning limitations. Conventional variables explained limited mental HRQoL variance, suggesting unmeasured psychological and cultural factors play a substantial role. While functional disability's primacy was consistent with Western evidence, secondary patterns diverged from Western cohorts. These findings underscore the need to incorporate psychological and culturally adapted measures into preoperative assessment.
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