Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland.
Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, New York.
J Knee Surg. 2020 Sep;33(9):875-883. doi: 10.1055/s-0039-1688769. Epub 2019 May 16.
Given that pain relief is often the primary goal of orthopaedic surgery, an accurate assessment of pain is paramount. The objectives of this cross-sectional analytical study were to (1) compare how the Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference (PI) computer adaptive test (CT) performs against the Numeric Pain Scale (NPS) measure in evaluating pain, and (2) to determine demographic, clinical, and psychosocial correlates of PI in an urban population undergoing a variety of knee surgeries. We hypothesized that there would be a strong correlation between PI and NPS, with minimal floor and ceiling effects; and that a worse PI score would be associated with a worse general health profile. The sample consisted of 412 patients undergoing knee surgery at an urban academic center. Patients were preoperatively administered measures of health-related quality of life (HRQOL). Bivariate and multivariable statistical analyses were performed to identify significant independent predictors. The mean PI score was 60.3 ± 7.2 and had no floor or ceiling effects, whereas NPS demonstrated a greater percentage of patients scoring at the extremes of the measure. Worse PI scores were associated with older age, higher body mass index (BMI), greater comorbidity, lower income, smoking, female gender, Hispanic ethnicity, Black race, unemployment, opioid use, lower expectations, and greater American Society of Anesthesiologists score ( < 0.05). Compared with other procedures, total knee arthroplasty was associated with worse PI scores and anterior cruciate ligament reconstruction was associated with better PI scores. Furthermore, PI demonstrated significant associations with a wide range of HRQOL measures. After controlling for confounding variables, worse PI was independently associated with older age, lower income, higher BMI, and smoking.
鉴于缓解疼痛通常是骨科手术的主要目标，因此准确评估疼痛至关重要。本横断面分析性研究的目的是：(1) 比较患者报告的结局测量信息系统 (PROMIS) 疼痛干扰 (PI) 计算机自适应测试 (CT) 与数字疼痛量表 (NPS) 在评估疼痛方面的表现；(2) 确定接受各种膝关节手术的城市人群中 PI 的人口统计学、临床和心理社会相关因素。我们假设 PI 与 NPS 之间存在很强的相关性，且地板效应和天花板效应最小；且 PI 评分越差与一般健康状况越差相关。该样本由在城市学术中心接受膝关节手术的 412 名患者组成。患者术前接受了健康相关生活质量 (HRQOL) 量表的测量。进行了双变量和多变量统计分析，以确定显著的独立预测因素。PI 的平均评分为 60.3 ± 7.2，且无地板效应或天花板效应，而 NPS 则显示出更多的患者在量表的极端处评分。PI 评分越差与年龄较大、体重指数 (BMI) 较高、合并症较多、收入较低、吸烟、女性、西班牙裔、黑人、失业、使用阿片类药物、期望较低和美国麻醉医师协会评分较高有关（ < 0.05）。与其他手术相比，全膝关节置换术与较差的 PI 评分相关，而前交叉韧带重建术与较好的 PI 评分相关。此外，PI 与广泛的 HRQOL 测量指标显著相关。在控制混杂变量后，PI 与年龄较大、收入较低、BMI 较高和吸烟独立相关。
