Department of Orthopaedic Surgery, University of Maryland, Baltimore, Maryland, USA.
Bone Joint J. 2022 Apr;104-B(4):479-485. doi: 10.1302/0301-620X.104B4.BJJ-2021-1089.R1.
The purpose of this study was to assess the prevalence of depression and anxiety symptoms in patients undergoing shoulder surgery using the National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) Depression and Anxiety computer adaptive tests, and to determine the factors associated with more severe symptoms. Additionally, we sought to determine whether PROMIS Depression and Anxiety were associated with functional outcomes after shoulder surgery.
This was a retrospective analysis of 293 patients from an urban population who underwent elective shoulder surgery from 2015 to 2018. Survey questionnaires included preoperative and two-year postoperative data. Bivariate analysis was used to identify associations and multivariable analysis was used to control for confounding variables.
Mean two-year PROMIS Depression and Anxiety scores significantly improved from preoperative scores, with a greater improvement observed in PROMIS Anxiety. Worse PROMIS Depression and Anxiety scores were also significantly correlated with worse PROMIS Physical Function (PF) and American Shoulder and Elbow Surgeons scores (ASES). After controlling for confounding variables, worse PROMIS Depression was an independent predictor of worse PROMIS PF, while worse PROMIS Anxiety was an independent predictor of worse PROMIS PF and ASES scores.
Mean two-year PROMIS Depression and Anxiety scores improved after elective shoulder surgery and several patient characteristics were associated with these scores. Worse functional outcomes were associated with worse PROMIS Depression and Anxiety; however, more severe two-year PROMIS Anxiety was the strongest predictor of worse functional outcomes. Cite this article: 2022;104-B(4):479-485.
本研究旨在使用美国国立卫生研究院（NIH）患者报告结局测量信息系统（PROMIS）抑郁和焦虑计算机自适应测试评估接受肩部手术患者的抑郁和焦虑症状的发生率，并确定与更严重症状相关的因素。此外，我们还试图确定 PROMIS 抑郁和焦虑与肩部手术后的功能结局是否相关。
这是一项对 2015 年至 2018 年间接受择期肩部手术的城市人群中的 293 例患者进行的回顾性分析。调查问卷包括术前和两年术后数据。采用双变量分析来确定关联，采用多变量分析来控制混杂变量。
平均两年的 PROMIS 抑郁和焦虑评分从术前评分显著改善，PROMIS 焦虑评分的改善更为明显。更差的 PROMIS 抑郁和焦虑评分也与更差的 PROMIS 躯体功能（PF）和美国肩肘外科医生评分（ASES）显著相关。在控制混杂变量后，更差的 PROMIS 抑郁是更差的 PROMIS PF 的独立预测因子，而更差的 PROMIS 焦虑是更差的 PROMIS PF 和 ASES 评分的独立预测因子。
择期肩部手术后，平均两年的 PROMIS 抑郁和焦虑评分有所改善，并且几个患者特征与这些评分相关。更差的功能结局与更差的 PROMIS 抑郁和焦虑相关；然而，更严重的两年 PROMIS 焦虑是更差的功能结局的最强预测因子。
2022;104-B（4）：479-485.
