Associations of preoperative patient mental health status and sociodemographic and clinical characteristics with baseline pain, function, and satisfaction in patients undergoing primary shoulder arthroplasty.
Associations of preoperative patient mental health status and sociodemographic and clinical characteristics with baseline pain, function, and satisfaction in patients undergoing primary shoulder arthroplasty.
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DOI：
10.1016/j.jse.2020.08.003
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发表时间：
2021-05
影响因子：
3
通讯作者：
Ricchetti ET
中科院分区：
文献类型：
--
作者：
Sahoo S;Derwin KA;Zajichek A;Cleveland Clinic Shoulder Group;Entezari V;Imrey PB;Iannotti JP;Ricchetti ET
肩部疼痛和功能障碍是肩关节置换术的常见适应症，但与这些症状相关的因素尚不完全清楚。本研究旨在调查接受初次肩关节置换术的患者和疾病特异性因素与术前患者报告结果测量 (PROM) 的关联。我们假设 VR-12 MCS 评估的较差心理健康状况、关节盂骨质流失和肩袖撕裂严重程度增加与术前较低的 PENN 肩部总评分 (PSS) 及其疼痛、功能和满意度子评分相关。前瞻性地确定了 12 个患者因素和 4 个疾病特异性因素，作为 3 年期间在单一机构接受初次肩关节置换术的患者术前 PROM 的可能统计预测因素。使用多变量统计模型和 Akaike 信息标准 (AIC) 比较来研究这些因素在解释术前 PSS 及其子评分变化时的独特关联性及其相对重要性。由 12 名外科医生完成的 788 例手术符合纳入标准，术前总 PSS 中位数为 31（疼痛 10，功能 18，满意度 1）。正如假设的那样，较低的 VR-12 MCS 与较低的术前 PSS 疼痛、功能和总分相关，但完整或小/中型肩袖撕裂的患者比具有大/大量上后肩袖撕裂的患者具有适度较低的 PSS 疼痛评分（即更多疼痛）。关节盂骨丢失与术前 PSS 无关。女性、受教育年限较少（对于所有四种结果）、较低的 VR-12 MCS 和术前阿片类药物使用（对于除满意度之外的所有结果）以及肩袖撕裂严重程度（仅对于疼痛）是与术前 PROM 最显着相关的因素。除了心理健康状况和肩袖撕裂状况外，患者性别、受教育年限和术前阿片类药物的使用与接受肩关节置换术的患者术前 PROM 最为显着相关。需要进一步研究来调查这些因素是否也能预测术后胎膜早破。
Shoulder pain and dysfunction are common indications for shoulder arthroplasty, yet the factors that are associated with these symptoms are not fully understood. This study aimed to investigate the associations of patient and disease-specific factors with preoperative patient-reported outcome measures (PROMs) in patients undergoing primary shoulder arthroplasty. We hypothesized that worse mental health status assessed by VR-12 MCS, glenoid bone loss, and increasing rotator cuff tear severity would be associated with lower preoperative total PENN Shoulder Score (PSS) and its pain, function, and satisfaction subscores. Twelve patient factors and four disease-specific factors were prospectively identified as possible statistical predictors for preoperative PROMs in patients undergoing primary shoulder arthroplasty at a single institution over a 3-year period. Multivariable statistical modeling and Akaike’s Information Criterion (AIC) comparisons were used to investigate the unique associations with, and relative importance of, these factors in accounting for variation in preoperative PSS and its subscores. 788 cases performed by 12 surgeons met inclusion criteria, with a preoperative median total PSS of 31 (pain 10, function 18, satisfaction 1). As hypothesized, lower VR-12 MCS was associated with lower preoperative PSS pain, function and total scores, but patients with intact or small/medium rotator cuff tears had modestly lower PSS pain scores (i.e., more pain) than patients with a large/massive superior-posterior rotator cuff tear. Glenoid bone loss was not associated with preoperative PSS. Female sex, fewer years of education (for all four outcomes), lower VR-12 MCS and preoperative opioid use (for all outcomes but satisfaction), and rotator cuff tear severity (for pain only) were the factors most prominently associated with preoperative PROMs. In addition to mental health status and rotator cuff tear status, patient sex, years of education, and preoperative opioid use were most prominently associated with preoperative PROMs in patients undergoing shoulder arthroplasty. Further studies are needed to investigate if these factors will also predict postoperative PROMs.
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影响因子：
--
作者：
Mattei, Lorenzo;Mortera, Stefano;Castoldi, Filippo
通讯作者：
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DOI：
10.1007/s11999.0000000000000270
发表时间：
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影响因子：
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