Long-term patient reported outcomes of elbow, wrist and hand surgery for rheumatoid arthritis
Long-term patient reported outcomes of elbow, wrist and hand surgery for rheumatoid arthritis
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DOI：
10.1111/1756-185x.13340
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发表时间：
2018-09-01
影响因子：
2.5
通讯作者：
Chikuda, Hirotaka
中科院分区：
文献类型：
--
作者：
Okura, Chisa;Ishikawa, Hajime;Chikuda, Hirotaka
目的：通过回顾性问卷调查调查类风湿性关节炎（RA）的肘部、腕部和手部手术的长期结果。方法：2002年1月至2003年12月期间，113名RA患者在我院接受了初次择期肘部、腕部或手部手术。为了评估术后10年的结果，使用询问治疗部位的原始问卷来评估患者报告的结果；还使用了修改后的斯坦福健康评估问卷 (mHAQ)。结果：从 67 名患者（98 个地点）获得了答复。术后10年，患者28关节疾病活动评分-红细胞沉降率(4)及改良健康评估问卷评分均显示明显改善。近 85% 的患者对手术部位的结果感到满意。感知改善的最常见原因是“疼痛减轻”（所有手术部位）。手指手术后经常报告“外观改善”，手腕和拇指手术后经常报告“力量增加”。对于肘部手术，30%的患者对运动和力量的增加感到满意。相比之下，大约 20% 的患者抱怨肘部和拇指手术后手术部位周围的力量下降。结论：我们最初的患者报告结果评估工具显示，肘部、腕部和手部手术为 RA 患者提供了持久的益处。虽然某些手术部位的疗效有所不同，但缓解疼痛是最有利的效果。改变的药物治疗也可能影响患者对 10 年后手术结果的感知。
Aim: A retrospective questionnaire survey was conducted to investigate the long-term outcomes of elbow, wrist and hand surgery for rheumatoid arthritis (RA).Methods: One hundred and thirteen RA patients underwent primary elective elbow, wrist or hand surgery at our hospital between January 2002 and December 2003. To evaluate the outcomes at 10 years after surgery, the patient-reported outcomes were assessed using an original questionnaire that inquired about the site of treatment; the modified Stanford Health Assessment Questionnaire (mHAQ) was also used.Results: Responses were obtained from 67 patients (98 sites). In the 10 years after surgery, the Disease Activity Score of 28 joint - erythrocyte sedimentation rate (4) and the modified Health Assessment Questionnaire scores of the patients showed significant improvement. Nearly 85% of patients were satisfied with the outcome at the surgical site. The most frequent reason for perceived improvement was 'pain relief' (all surgical sites). An 'improved appearance' was frequently reported after finger surgery and 'increased power' was frequently reported after wrist and thumb surgeries. With regard to elbow surgery, 30% of the patients were satisfied with the increase in motion and power. In contrast, approximately 20% of patients complained of decreased power around the surgical site after elbow and thumb surgeries.Conclusions: Our original patient-reported outcome assessment tool revealed that elbow, wrist and hand surgery provided long-lasting benefits in RA patients. While the efficacy differed in some of the surgical sites, pain relief was the most favorable effect. Altered medical therapy may also have impacted the patient-perceived outcomes of surgery at 10 years.