患者回忆的肩关节置换术后术前疼痛比最初报告的更严重:一项使用美国肩肘外科医师评分的回忆准确性研究。

Patients recall worse preoperative pain after shoulder arthroplasty than originally reported: a study of recall accuracy using the American Shoulder and Elbow Surgeons score.

作者信息

Lowe Jeremiah T, Li Xinning, Fasulo Sydney M, Testa Edward J, Jawa Andrew

机构信息

New England Baptist Hospital, Boston, MA, USA; Boston Sports and Shoulder Center, Waltham, MA, USA.

Boston Medical Center, Boston, MA, USA.

出版信息

J Shoulder Elbow Surg. 2017 Mar;26(3):506-511. doi: 10.1016/j.jse.2016.09.004. Epub 2016 Oct 14.

Abstract

BACKGROUND

Patient-reported outcome measures (PROMs) are valuable tools for quantifying outcomes of orthopedic surgery. However, when baseline scores are not obtained, there is considerable controversy about whether PROMs can be administered retrospectively for patients to recall their preoperative state. We investigated the accuracy of patient recall after total shoulder arthroplasty (TSA) using the American Shoulder and Elbow Surgeons (ASES) assessment score.

METHODS

Recalled ASES scores were collected postoperatively at 6 weeks, 3 months, 6 months, and 12 months from 169 patients who previously completed baseline scores before TSA. The ASES total score was divided into its two subcomponents: functional ability and visual analog scale (VAS) for pain. We compared preoperative and recalled scores for each subcomponent and the total ASES score.

RESULTS

Recalled ASES function scores were comparable to corresponding preoperative scores across all time points (analysis of variance, P = .21), but recalled VAS pain was significantly higher at all time points beyond 6 weeks after surgery (P = .0001 at 3 months; P = .005 at 6 months; and P = .001 at 12 months). As a result, the ASES total score was only comparable at 6 weeks after surgery (P = .39) and differed at all time points thereafter.

CONCLUSION

Patients are able to recall preoperative function with considerable accuracy for up to 12 months after TSA. However, beyond 6 weeks postoperatively, patients recall having worse pain than they originally reported, and recalled ASES total scores are unreliable as a result.

摘要

背景

患者报告结局测量(PROMs)是量化骨科手术结局的重要工具。然而,当未获取基线评分时,对于PROMs是否可用于让患者回顾其术前状态进行回顾性评估存在相当大的争议。我们使用美国肩肘外科医师(ASES)评估评分调查了全肩关节置换术(TSA)后患者回忆的准确性。

方法

从169例术前已完成基线评分的TSA患者中,于术后6周、3个月、6个月和12个月收集回忆的ASES评分。ASES总分分为两个子部分:功能能力和疼痛视觉模拟量表(VAS)。我们比较了每个子部分以及ASES总分的术前和回忆评分。

结果

在所有时间点,回忆的ASES功能评分与相应的术前评分相当(方差分析,P = 0.21),但术后6周后所有时间点回忆的VAS疼痛均显著更高(3个月时P = 0.0001;6个月时P = 0.005;12个月时P = 0.001)。因此,ASES总分仅在术后6周时相当(P = 0.39),此后在所有时间点均有差异。

结论

患者在TSA后长达12个月内能够相当准确地回忆术前功能。然而,术后6周后,患者回忆的疼痛比他们最初报告的更严重,因此回忆的ASES总分不可靠。

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