Chrencik Matthew T, Ventimiglia Dominic J, Schneider Matheus B, Zhang Tina, Fisher Kalin J, Hahn Alexander, Gilotra Mohit N, Hasan S Ashfaq, Henn R Frank
Department of Orthopaedic Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.
J Orthop. 2021 Aug 16;27:49-55. doi: 10.1016/j.jor.2021.08.010. eCollection 2021 Sep-Oct.
The objective of this study was to identify preoperative characteristics associated with worse Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference (PI) two years after shoulder surgery.
This was a retrospective analysis of prospectively collected data on 293 patients who underwent elective shoulder surgery. Survey questionnaires were collected within one week of surgery and then two years postoperatively. Bivariate analysis was used to identify associations and multivariable analysis was used to control for confounding variables.
Worse two-year PROMIS PI was significantly correlated with older age, higher BMI, greater comorbidities, more prior surgeries, and multiple socio-demographic factors. Less improvement in PROMIS PI was significantly correlated with greater comorbidities, more previous surgeries, unemployment, prior orthopaedic surgery on the operative joint, and a higher American Society of Anesthesiologists (ASA) score. Better scores on all preoperative patient-reported outcome measures correlated with better two-year PROMIS PI. Multivariable analysis demonstrated that worse two-year PROMIS PI was independently predicted by the following preoperative factors: Workers' Compensation claim, opioid use, worse whole body Numeric Pain Score, and worse PROMIS PI. Less improvement in two-year PROMIS PI was predicted by the same preoperative factors.
Worse PROMIS PI after shoulder surgery was associated with older age, greater comorbidities, mental health impairment, and lower socioeconomic status. Preoperative predictors of worse pain interference two years after shoulder surgery included Workers' Compensation, opioid use, worse whole body pain, and worse PROMIS PI.
III.
本研究的目的是确定与肩部手术后两年患者报告结局测量信息系统（PROMIS）疼痛干扰（PI）较差相关的术前特征。
这是一项对293例行择期肩部手术患者的前瞻性收集数据的回顾性分析。在手术一周内及术后两年收集调查问卷。采用双变量分析确定关联，并采用多变量分析控制混杂变量。
两年时PROMIS PI较差与年龄较大、体重指数较高、合并症较多、既往手术较多以及多种社会人口学因素显著相关。PROMIS PI改善较少与合并症较多、既往手术较多、失业、手术关节既往骨科手术以及美国麻醉医师协会（ASA）评分较高显著相关。所有术前患者报告结局指标得分较高与两年时PROMIS PI较好相关。多变量分析表明，两年时PROMIS PI较差由以下术前因素独立预测：工伤赔偿申请、阿片类药物使用、全身数字疼痛评分较差以及PROMIS PI较差。两年时PROMIS PI改善较少由相同的术前因素预测。
肩部手术后PROMIS PI较差与年龄较大、合并症较多、心理健康受损以及社会经济地位较低相关。肩部手术后两年疼痛干扰较差的术前预测因素包括工伤赔偿、阿片类药物使用、全身疼痛较差以及PROMIS PI较差。
III级。
