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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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats: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 (\u03b2 = \u22120.37), non-Chinese ethnicity, primary education or below relative to higher levels, and history of accident or trauma (\u03b2 = \u22120.11). 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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats: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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11136-026-04257-1","type":"journal-article","created":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T21:03:10Z","timestamp":1777842190000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Factors associated with preoperative health-related quality of life in patients undergoing lumbar spine surgery: a multi-ethnic Asian cohort"],"prefix":"10.1007","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6135-508X","authenticated-orcid":false,"given":"Xun","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5432-4305","authenticated-orcid":false,"given":"Calvin Wei Jie","family":"Chern","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0200-3331","authenticated-orcid":false,"given":"Alex Quok An","family":"Teo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9237-2586","authenticated-orcid":false,"given":"Jiong Hao Jonathan","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7261-1255","authenticated-orcid":false,"given":"Annushiah","family":"Vasan Thakumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7980-6979","authenticated-orcid":false,"given":"Nan","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2012-9835","authenticated-orcid":false,"given":"Hwee Weng Dennis","family":"Hey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5338-578X","authenticated-orcid":false,"given":"Ling Jie","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,3]]},"reference":[{"key":"4257_CR1","unstructured":"Global Burden of Disease Collaborative Network. 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He did not receive research grants from the EuroQol Research Foundation for this work and was not involved in the editorial handling or decision-making process for this manuscript. No other conflicts of interest were declared.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the Declaration of Helsinki. Ethical approval was obtained from the Domain Specific Review Board of the National Healthcare Group, Singapore (reference number: 2025-1733).","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"A waiver of informed consent was granted because the study used anonymised registry data collected as part of routine clinical care.","order":3,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Dr Ling Jie Cheng is supported by a National University of Singapore Overseas Postdoctoral Fellowship under the Singapore Teaching and Academic Research Talent (START) Award and by a National University of Singapore Developmental Grant.","order":4,"name":"Ethics","label":"Funding\/Support","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The views expressed in this article are those of the authors and do not necessarily reflect the views of the EuroQol Group. Parts of this work have been submitted to ISPOR 2026 (Philadelphia, PA, USA), the 3rd EuroQol UK and Ireland Regional Meeting 2026 (Sheffield, UK), and the 3rd EuroQol Asia Regional Meeting 2026 (Singapore).","order":5,"name":"Ethics","label":"Disclaimer","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"144"}}