1 Evans Army Community Hospital, Ft Carson, CO, USA.
2 Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
Foot Ankle Int. 2018 Dec;39(12):1444-1448. doi: 10.1177/1071100718788507. Epub 2018 Jul 27.
: Patient-reported outcome measures (PROMs) are taking a more prominent role in orthopedics as health care seeks to define treatment outcomes. The visual analog scale (VAS) is considered a reliable measure of acute pain. A previous study found that operative candidates' VAS pain score was significantly higher when reported to the surgeon compared to the nurse. This study's aim is to examine whether this phenomenon occurs in patients that do not undergo an operative procedure. We hypothesized that patients' VAS pain scores reported to the surgeon vs the nurse would be the same.
: This study is a retrospective cohort of 201 consecutive nonoperative foot and ankle patients treated by a single surgeon. Patients were asked to rate pain intensity by a nurse followed by the surgeon using a horizontal VAS, 0 "no pain" to 10 "worst pain." Differences in reported pain levels were compared with data from the previous cohort of 201 consecutive operative foot and ankle patients.
: The mean VAS score reported to the nurse was 3.2 whereas the mean VAS score reported to the surgeon was 4.2 ( P < .001). The mean difference in VAS scores reported for operative patients was 2.9, whereas the mean difference for nonoperative patients was 1.0 ( P < .001).
: This study found statistically significant differences between VAS pain scores reported to the surgeon vs the nurse in nonoperative patients. These results support the trend found in our previous study, where operative patients reported significantly higher pain scores to the surgeon vs the nurse. The mean difference between reported pain scores was significantly higher for operative patients compared to nonoperative patients.
: Level III, comparative study.
随着医疗保健行业努力定义治疗效果，患者报告的结果测量（PROM）在骨科领域的作用越来越重要。视觉模拟评分（VAS）被认为是衡量急性疼痛的可靠方法。先前的一项研究发现，与护士相比，手术候选者向外科医生报告的 VAS 疼痛评分明显更高。本研究旨在检查这种现象是否发生在不进行手术的患者中。我们假设患者向外科医生和护士报告的 VAS 疼痛评分相同。
这是一项回顾性队列研究，共纳入 201 例由一位外科医生治疗的非手术足部和踝关节患者。患者首先由护士评估疼痛强度，然后由外科医生使用水平 VAS 评估，范围为 0“无痛”至 10“最痛”。比较了向外科医生和护士报告的疼痛水平差异与之前 201 例连续手术足部和踝关节患者的队列数据。
向护士报告的 VAS 平均得分为 3.2，而向外科医生报告的 VAS 平均得分为 4.2（P<0.001）。手术患者报告的 VAS 评分差异的平均值为 2.9，而非手术患者的平均值为 1.0（P<0.001）。
本研究发现，非手术患者向外科医生和护士报告的 VAS 疼痛评分存在统计学显著差异。这些结果支持我们之前研究中发现的趋势，即手术患者向外科医生报告的疼痛评分明显高于向护士报告的疼痛评分。与非手术患者相比，报告疼痛评分的平均差异在手术患者中显著更高。
III 级，比较研究。
