Felder John M, Ducic Ivica
Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St. Louis, St. Louis, Mo.
Washington Nerve Institute, McLean, Va.
Plast Reconstr Surg Glob Open. 2021 May 21;9(5):e3570. doi: 10.1097/GOX.0000000000003570. eCollection 2021 May.
Little emphasis has been paid to characterize quality of life (QoL) burdens experienced by patients seeking surgical treatment for nerve injuries and neuropathic pain.
A cross-sectional survey was distributed to all patients (N = 767) from a single nerve surgeon's practice between 2014 and 2019. Data collected included demographics, specifics of the injury and symptoms, time to referral, and effects of the injury, surgery, and timing of surgery on QoL.
Of the 767 patients, 209 (27.2%) completed the survey. Average age was 48.8 years; 68.9% of patients were women and 31.1% men. At presentation, 68% had experienced symptoms for more than 1 year; 86.1% reported severity as being profound; 97.6% reported QoL was at least moderately negatively impacted by nerve injury; 70% felt they should have been referred earlier for surgical evaluation; 51.2% were not told that nerve surgery was an option for their problem; 83.1% felt that earlier referral would have improved their QoL. After surgery, symptoms were significantly mitigated in 55.5% of the patients, moderately mitigated in 21.5%. Patients reported QoL was significantly (59.8%) or at least moderately (76.6%) improved by nerve surgery.
The majority of patients reported that nerve injuries imparted a moderate to severe impact on QoL, and that surgical treatment improved QoL. Most patients felt that earlier referral for surgical intervention would have led to better outcome and positively impacted QoL. Interdisciplinary treatment algorithms, including a role for surgical intervention, may be helpful in facilitating timely diagnosis, referral, and thus improved outcomes.
对于寻求手术治疗神经损伤和神经性疼痛的患者所经历的生活质量（QoL）负担，人们很少关注其特征描述。
对一位神经外科医生在2014年至2019年期间接诊的所有患者（N = 767）进行了横断面调查。收集的数据包括人口统计学信息、损伤和症状的具体情况、转诊时间，以及损伤、手术和手术时机对生活质量的影响。
767名患者中，209名（27.2%）完成了调查。平均年龄为48.8岁；68.9%的患者为女性，31.1%为男性。就诊时，68%的患者症状出现超过1年；86.1%的患者报告症状严重；97.6%的患者报告神经损伤至少对生活质量有中度负面影响；70%的患者认为他们应该更早转诊进行手术评估；51.2%的患者未被告知神经手术是解决其问题的一种选择；83.1%的患者认为更早转诊会改善他们的生活质量。手术后，55.5%的患者症状明显减轻，21.5%的患者症状中度减轻。患者报告神经手术使生活质量显著（59.8%）或至少中度（76.6%）改善。
大多数患者报告神经损伤对生活质量有中度至重度影响，手术治疗可改善生活质量。大多数患者认为更早转诊进行手术干预会带来更好的结果，并对生活质量产生积极影响。包括手术干预作用的多学科治疗算法可能有助于促进及时诊断、转诊，从而改善治疗结果。
