Hamilton and Toronto, Ontario, Canada From the Division of Plastic Surgery and the Surgical Outcomes Research Center, Department of Surgery, the Department of Clinical Epidemiology and Biostatistics, and the Offord Center for Child Studies, Department of Psychiatry and Behavioral Neurosciences, McMaster University; and the Leslie Dan Faculty of Pharmacy, University of Toronto.
Plast Reconstr Surg. 2014 Jun;133(6):1411-1419. doi: 10.1097/PRS.0000000000000177.
The present study was undertaken to assess the health-related quality of life in patients with Dupuytren's disease who undergo palmar fasciectomy.
A prospective cohort of patients with Dupuytren's disease undergoing palmar and/or digital fasciectomy was recruited from the practice of three plastic surgeons in Hamilton, Ontario, Canada. After written informed consent was obtained, participants were asked to complete three health-related quality-of-life questionnaires (i.e., Short Form-36, Michigan Hand Outcomes Questionnaire, and Health Utility Index Mark 3) at five time points: at 1 week and 1 day preoperatively, and at 1, 3, 6, and 12 months postoperatively. Ranges of motion and grip strength measurement were also recorded.
For the 26 patients in the study, the multiattribute scores of the Health Utility Index Mark 3 improved from 0.80 before surgery to 0.83 at 12 months postoperatively (p > 0.05). There was no difference in the Short Form-36 scores, but the Michigan Hand Outcomes Questionnaire scores improved from 74 at 1 week preoperatively to 90 at the 12-month postoperative visit (p < 0.001).
Patients who undergo palmar fasciectomy for Dupuytren's disease experience a substantial improvement in their health-related quality of life 12 months after surgery. In the authors' study population, a benefit of 0.85 quality-adjusted life-year within 12 months was observed. This can be translated as follows: the average patient who undergoes palmar fasciectomy gains the equivalent of approximately 14.4 days (0.48 months) in perfect health by undergoing palmar fasciectomy.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
本研究旨在评估接受掌侧筋膜切开术的杜普伊特伦氏病患者的健康相关生活质量。
从加拿大安大略省汉密尔顿的三位整形外科医生的实践中招募了接受掌侧和/或指侧筋膜切开术的杜普伊特伦氏病患者的前瞻性队列。获得书面知情同意后，要求参与者在五个时间点完成三个健康相关生活质量问卷（即 36 项简短健康调查、密歇根手部结果问卷和健康效用指数标记 3）：术前 1 周和 1 天，以及术后 1、3、6 和 12 个月。还记录了关节活动度和握力测量值。
在研究的 26 名患者中，健康效用指数标记 3 的多属性评分从手术前的 0.80 提高到术后 12 个月的 0.83（p>0.05）。36 项简短健康调查评分没有差异，但密歇根手部结果问卷评分从术前 1 周的 74 分提高到术后 12 个月的 90 分（p<0.001）。
接受掌侧筋膜切开术治疗杜普伊特伦氏病的患者在手术后 12 个月时健康相关生活质量有显著改善。在作者的研究人群中，在 12 个月内观察到 0.85 个质量调整生命年的获益。这可以转化为：接受掌侧筋膜切开术的平均患者在接受掌侧筋膜切开术后，在完美健康状态下获得了大约 14.4 天（0.48 个月）的等效时间。
临床问题/证据水平：治疗，IV。
