Prediction of post-interventional physical function in diabetic foot ulcer patients using patient reported outcome measurement information system (PROMIS).
Prediction of post-interventional physical function in diabetic foot ulcer patients using patient reported outcome measurement information system (PROMIS).
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使用患者报告结果测量信息系统（PROMIS）预测糖尿病足溃疡患者的介入治疗后身体功能。
DOI：
10.1016/j.fas.2020.04.009
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Oh I
中科院分区：
文献类型：
--
作者：
Hao SP;Houck JR;Waldman OV;Baumhauer JF;Oh I
感染的糖尿病足溃疡（DFU）患者表现出基线身体功能（PF）受损，通过手术干预治疗感染可能会进一步损害该功能。尚未研究DFU人群中手术干预对患者报告结局测量信息系统（PROMIS）PF的影响。我们假设术前PROMIS评分（PF、疼痛干扰（PI）、抑郁）结合相关临床因素可用于预测DFU患者的术后PF。确定了2015年2月至2018年11月期间来自单一学术医生实践的DFU患者（n = 240）。92例患者符合入选标准，具有完整的随访和PROMIS计算机自适应检测记录。收集了人口统计学和临床因素、进行的手术和伤口愈合状态。将斯皮尔曼等级相关系数、卡方检验和多维建模应用于所有变量的术前和术后值，以评估患者的术后PF。平均年龄为60.5（33 - 96）岁，平均随访时间为4.7（3 - 12）个月。超过70%的患者的初始PF比美国人群低2 - 3个标准差（n = 49; 28）。术前PF（p <0.01），PI（p <0.01），抑郁（p <0.01），CRF（p <0.02）和截肢水平（p <0.04）显示与术后PF具有显著的单变量相关性。（r = 0.55）表明，初始PF（p = 0.004），截肢水平（p = 0.008），和伤口愈合状态（p = 0.001）预测术后PF。大多数DFU患者的基线PF较差。术前PROMIS评分（PF、PI、抑郁）可预测DFU患者术后PROMIS PF。术后患者的身体功能可通过PF术后= 29.42 + 0.34（PF初始）-5.87（未愈合）-2.63（截肢类别）进行评估。该算法可以作为预测术后身体功能和设定期望的有价值的工具。
Infected diabetic foot ulcer (DFU) patients present with an impaired baseline physical function (PF) that can be further compromised by surgical intervention to treat the infection. The impact of surgical interventions on Patient Reported Outcomes Measurement Information System (PROMIS) PF within the DFU population has not been investigated. We hypothesize that preoperative PROMIS scores (PF, Pain Interference (PI), Depression) in combination with relevant clinical factors can be utilized to predict postoperative PF in DFU patients. DFU patients from a single academic physician’s practice between February 2015 and November 2018 were identified (n=240). Ninety-two patients met inclusion criteria with complete follow-up and PROMIS computer adaptive testing records. Demographic and clinical factors, procedure performed, and wound healing status were collected. Spearman’s rank correlation coefficient, Chi-Squared tests and multidimensional modelling were applied to all variables’ pre- and postoperative values to assess patients’ postoperative PF. The mean age was 60.5 (33–96) years and mean follow-up was 4.7 (3–12) months. Over 70% of the patients’ initial PF were 2 to 3 standard deviations below the US population (n = 49; 28). Preoperative PF (p < 0.01), PI (p < 0.01), Depression (p < 0.01), CRF (p < 0.02) and amputation level (p < 0.04) showed significant univariate correlation with postoperative PF. Multivariate model (r = 0.55) showed that the initial PF (p = 0.004), amputation level (p = 0.008), and wound healing status (p = 0.001) predicted postoperative PF. Majority of DFU patients present with poor baseline PF. Preoperative PROMIS scores (PF, PI, Depression) are predictive of postoperative PROMIS PF in DFU patients. Postoperative patient’s physical function can be assessed by PFpostoperative = 29.42 + 0.34 (PFinitial) – 5.87 (Not Healed) – 2.63 (Amputation Category). This algorithm can serve as a valuable tool for predicting post-operative physical function and setting expectations.
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