Persistent iliac crest donor site pain: Independent outcome assessment
Persistent iliac crest donor site pain: Independent outcome assessment
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DOI：
10.1097/00006123-200203000-00015
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发表时间：
2002-03-01
期刊：
影响因子：
4.8
通讯作者：
Brotea, C
中科院分区：
文献类型：
--
作者：
Heary, RF;Schlenk, RP;Brotea, C
目的：本研究通过独立的结果分析客观地定义供区疼痛的发生率。此外，本研究还发现，当独立的结果评估结果与由外科医生记录的检查结果确定的发生率进行比较时，观察到显著的差异。方法：回顾了由单一神经外科医生进行髂骨移植手术的患者。髂嵴供区疼痛的存在，在远离手术的时间，由特定的询问确定，并记录在神经外科医生的书面评估中，与通过结构化电话问卷访谈获得的独立评估结果进行比较。在4年期间，105例患者符合纳入标准。所有研究患者均完成了手术外科医生和独立采访者的随访评估。疼痛被分为三类，即无疼痛、可接受的疼痛和不可接受的疼痛。患者还被要求通过视觉模拟量表评估其供体部位疼痛的严重程度。统计分析比较手术医师评估和独立评估时髂嵴供区疼痛的发生率。结果：当在远离手术的时间进行评估时，移植手术后髂嵴供体部位疼痛的真实发生率（34%）明显高于神经外科医生之前的估计（8%）。虽然31%的患者有偶尔或轻微的疼痛，但只有3%的患者经历了不可接受的疼痛。结论：在术前讨论供区发病率时，应向患者提供独立的结果评估值。基于独立观察的客观结果分析对于最准确地解释髂嵴供区疼痛的感知至关重要。
OBJECTIVE: This study objectively defines the incidence of donor site pain in an independent outcome analysis. In addition, this study identifies the significant discrepancies that are observed when independent outcome assessment results are compared with the incidences determined by review of the operating surgeon's documented findings.METHODS: A review of patients who underwent iliac bone graft harvesting by a single neurosurgeon was conducted. The presence of iliac crest donor site pain, at a time remote from surgery, as determined by specific questioning and recorded in the neurosurgeon's written evaluation was compared with independent assessment findings obtained in structured telephone questionnaire interviews. During a 4-year period, 105 patients met the inclusion criteria. Both the operating surgeon's and independent interviewer's follow-up evaluations were completed for all study patients. Pain was classified into three categories, i.e., no pain, acceptable pain, or unacceptable pain. Patients were also asked to assess the severity of their donor site pain by using a visual analog scale. Statistical analyses comparing the incidences of iliac crest donor site pain in the operating surgeon's evaluations and the independent assessments were performed.RESULTS: When evaluated at a time remote from surgery, the true incidence of iliac crest donor site pain after graft harvest procedures (34%) was significantly greater than previously appreciated by the neurosurgeon (8%). Although occasional or mild pain was observed for 31% of patients, only 3% of all patients experienced unacceptable pain.CONCLUSION: Independent outcome assessment values should be provided to patients in preoperative discussions regarding donor site morbidity. Objective outcome analysis, based on independent observations, is crucial for the most accurate interpretation of perceptions of iliac crest donor site pain.