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桡骨远端骨折六个月后疼痛和残疾的预测因素:患者因素与损伤因素对比

Patient versus injury factors as predictors of pain and disability six months after a distal radius fracture.

作者信息

MacDermid Joy C, Donner A, Richards Robert S, Roth James H

机构信息

School of Rehabilitation Science, McMaster University, Ontario, Hamilton, Canada.

出版信息

J Clin Epidemiol. 2002 Sep;55(9):849-54. doi: 10.1016/s0895-4356(02)00445-6.

Abstract

A prospective cohort of 120 patients with distal radius fractures completed a baseline evaluation that determined their age, sex, education level, injury compensation status, AO fracture type, prereduction radial shortening, and postreduction radial shortening. Six months later patients self-reported pain and disability using the Patient-Rated Wrist Evaluation, and were tested for physical impairment (grip, wrist range of motion, and dexterity). Univariate and forward stepwise regression analyses agreed that the most influential predictor of pain and disability at 6 months was injury compensation. Patient education level and prereduction radial shortening also contributed predictive information (R squared = 25%). Wrist impairment was moderately correlated with patient reported pain and disability (r = 0.50). Both impairment and disability measures are required to fully describe outcomes. Further work is required to delineate additional factors that contribute to outcome.

摘要

一项针对120例桡骨远端骨折患者的前瞻性队列研究完成了基线评估,该评估确定了他们的年龄、性别、教育水平、损伤赔偿状况、AO骨折类型、复位前桡骨短缩情况以及复位后桡骨短缩情况。六个月后,患者使用患者自评腕关节评估量表自我报告疼痛和功能障碍情况,并接受身体功能障碍测试(握力、腕关节活动范围和灵活性)。单因素分析和向前逐步回归分析均表明,损伤赔偿是6个月时疼痛和功能障碍最具影响力的预测因素。患者教育水平和复位前桡骨短缩情况也提供了预测信息(决定系数R² = 25%)。腕关节功能障碍与患者报告的疼痛和功能障碍中度相关(r = 0.50)。需要同时采用功能障碍和功能丧失的评估指标才能全面描述治疗结果。需要进一步开展研究以明确影响治疗结果的其他因素。

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