Asher Marc, Lai Sue Min, Burton Doug, Manna Barbara
Kansas University Medical Center, Kansas City, Kansas USA.
Stud Health Technol Inform. 2002;91:462-4.
To determine whether either spine or trunk deformity measurements correlate with patients quality of life questionnaire responses.
Forty five pre operative patients (5M, 40F), average age 15 years, 9 months (range, 10-20) met the inclusion criteria of age (< or = 20 years), Posterior Trunk Symmetry Index (POTSI) and Suzuki Hump Sum (SHS) determination from surface topography, and Scoliosis Research Society-22 (SRS-22)patient questionnaire completion. Average measurement and measurement ranges were largest Cobb 62 degrees (range, 40-137 degrees), POTSI 49 (range, 17-149), SHS 16 (5-32), and SRS-22 subtotal score 3.86 (range, 4.7-2.35). The individual SRS-22 domain scores were function 4.13 (4.80-2.20), pain 4.01 (5-1.60), self image 3.34 (4.4-1.80) and mental health 4.01 (5-1.80). (Scale 5 Best-1 Worst). Correlations between deformity and questionnaire measurements were determined, p<0.01 considered significant.
Spine deformity (Cobb) correlated with the SRS-22 subtotal scores (cc-04207, p<0.005) and with the function and self image SRS-22 domain scores: cc0.5182, p<0.001) and cc-0.3981, p<0.01 respectively. Neither trunk deformity score correlated with the SRS-22 Score: POTSI versus SRS-22 (cc 0.0449, ns) and SHS versus SRS-22 (cc-0.0311, ns)
Spine deformity correlates well with quality of life questionnaire responses whereas trunk deformity magnitude does not. This is somewhat surprising as it is the trunk deformity that the patient can they themselves see. These findings illustrate the pitfalls of assuming what is important to the patient based on clinical measurements.
确定脊柱或躯干畸形测量值是否与患者生活质量问卷的回答相关。
45例术前患者(5例男性,40例女性),平均年龄15岁9个月(范围10 - 20岁),符合年龄(≤20岁)、通过表面地形测量后躯干对称指数(POTSI)和铃木驼峰总和(SHS)以及完成脊柱侧弯研究协会-22(SRS - 22)患者问卷的纳入标准。平均测量值及测量范围为最大Cobb角62度(范围40 - 137度),POTSI为49(范围17 - 149),SHS为16(5 - 32),SRS - 22总分3.86(范围4.7 - 2.35)。SRS - 22各领域得分分别为:功能4.13(4.80 - 2.20),疼痛4.01(5 - 1.60),自我形象3.34(4.4 - 1.80),心理健康4.01(5 - 1.80)。(量表5为最佳 - 1为最差)。确定畸形与问卷测量值之间的相关性,p<0.01认为具有显著性。
脊柱畸形(Cobb角)与SRS - 22总分(cc - 0.4207,p<0.005)以及功能和自我形象SRS - 22领域得分相关:分别为cc0.5182,p<0.001和cc - 0.3981,p<0.01。两种躯干畸形评分均与SRS - 22评分不相关:POTSI与SRS - 22(cc 0.0449,无显著性差异)以及SHS与SRS - 22(cc - 0.0311,无显著性差异)。
脊柱畸形与生活质量问卷的回答相关性良好,而躯干畸形程度则不然。这有点令人惊讶,因为患者自己能看到的是躯干畸形。这些发现说明了基于临床测量来假定对患者重要的因素存在的缺陷。