Zwaan Eva, Cheung Elena, IJsselmuiden Alexander, Holtzer Carlo, Schreuders Ton, Kofflard Marcel, Alings Marco, Coert J Henk
Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.
Department of Cardiology, Amphia Hospital, Breda, the Netherlands.
Patient Relat Outcome Meas. 2022 Jun 27;13:145-155. doi: 10.2147/PROM.S353895. eCollection 2022.
The use of the Disability of the Arm, Shoulder and Hand (DASH) questionnaire and its shortened version, the DASH, have been used to assess upper extremity function following a transradial percutaneous coronary intervention (TR-PCI). However, the use of these scores has not yet been validated for TR-PCI induced complications in the upper extremity. The aim of this study was to establish the validity of the DASH and the DASH, for the assessment of upper extremity dysfunction following a transradial percutaneous coronary intervention (TR-PCI).
This study was a diagnostic retrospective analysis of the ARCUS study, of whom 440 underwent TR-PCI and 62 control patients were treated via the transfemoral approach. All participants completed the DASH and DASH questionnaire prior to the procedure and at each follow-up visit up to six months of follow-up. Receiver operating characteristics (ROC) were constructed to determine the validity of the questionnaires, using physical examinations to determine the occurrence of upper extremity dysfunction, according to the ARCUS study.
At each follow-up moment, the area under the curve (AUC) showed a poor ability of the DASH and DASH to discriminate between patients with and without upper extremity dysfunction (AUC: 0.565-0.586). There was no significant difference between the questionnaires (p > 0.05).
The DASH and DASH questionnaires are both equally incapable of discriminating between patients with and without upper extremity dysfunction following a TR-PCI. Study results suggest that the DASH and DASH questionnaires are incapable of discerning changes in upper extremity function as a result of procedural complications following a TR-PCI vs cardiac induced activity cessation.
手臂、肩部和手部功能障碍（DASH）问卷及其简化版（简版DASH）已被用于评估经桡动脉冠状动脉介入治疗（TR-PCI）后的上肢功能。然而，这些评分在评估TR-PCI引起的上肢并发症方面尚未得到验证。本研究的目的是确定DASH问卷和简版DASH问卷在评估经桡动脉冠状动脉介入治疗（TR-PCI）后上肢功能障碍方面的有效性。
本研究是对ARCUS研究的诊断性回顾分析，其中440例患者接受了TR-PCI，62例对照患者通过股动脉途径进行治疗。所有参与者在手术前以及随访至6个月的每次随访时均完成了DASH问卷和简版DASH问卷。根据ARCUS研究，构建受试者工作特征（ROC）曲线以确定问卷的有效性，采用体格检查来确定上肢功能障碍的发生情况。
在每次随访时，曲线下面积（AUC）显示DASH问卷和简版DASH问卷在区分有无上肢功能障碍患者方面能力较差（AUC：0.565 - 0.586）。问卷之间无显著差异（p > 0.05）。
DASH问卷和简版DASH问卷在区分TR-PCI后有无上肢功能障碍的患者方面同样能力不足。研究结果表明，DASH问卷和简版DASH问卷无法辨别TR-PCI术后因手术并发症导致的上肢功能变化与心脏活动停止导致的变化。
