Clement N D, Duckworth A D, Jenkins P J, McEachan J E
Department of Orthopaedic Surgery, Queen Margaret Hospital, Dunfermline, UK
Department of Orthopaedic Surgery, Queen Margaret Hospital, Dunfermline, UK.
J Hand Surg Eur Vol. 2016 Jul;41(6):624-31. doi: 10.1177/1753193415622341. Epub 2016 Jan 7.
We studied the correlation between change in the QuickDASH score and the absolute post-operative QuickDASH score with patient satisfaction after open carpal tunnel decompression. Threshold values in the QuickDASH score, the point at which the sensitivity and specificity are maximal in predicting patient satisfaction, were identified. During the study period, outcome data were compiled for 937 carpal tunnel decompressions, which included 219 (23%) male and 718 (77%) female patients with a mean age of 58 years (standard deviation (SD) 14). There was a significant improvement (mean difference 32, 95% confidence interval (CI) 30 to 34) in the QuickDASH from a mean of 54 (SD 20) to 22 (SD 23) at 1 year after surgery. There were 808 (86%) patients who defined their outcome as satisfactory at 1 year. The identified threshold values for the post-operative QuickDASH score (⩽34 points) and the change (⩾20 points) in the score were highly predictive of patient satisfaction. However, these threshold values varied significantly according to the baseline pre-operative score. The threshold values identified in the QuickDASH can be used to interpret the score. However, the influence of the pre-operative baseline score should be taken into account when comparing different cohorts of patients or using the values to power future studies.
Prognosis, observational cohort study.
我们研究了开放性腕管减压术后QuickDASH评分的变化与术后绝对QuickDASH评分和患者满意度之间的相关性。确定了QuickDASH评分中的阈值，即预测患者满意度时敏感性和特异性最高的点。在研究期间，收集了937例腕管减压术的结果数据，其中包括219例（23%）男性和718例（77%）女性患者，平均年龄58岁（标准差（SD）14）。术后1年时，QuickDASH评分从平均54分（SD 20）显著改善至22分（SD 23）（平均差异32，95%置信区间（CI）30至34）。1年时有808例（86%）患者将其结果定义为满意。术后QuickDASH评分（≤34分）和评分变化（≥20分）的确定阈值对患者满意度具有高度预测性。然而，这些阈值根据术前基线评分有显著差异。QuickDASH中确定的阈值可用于解释评分。然而，在比较不同患者队列或使用这些值为未来研究提供动力时，应考虑术前基线评分的影响。
证据水平IV：预后，观察性队列研究。
