术前患者期望较高预示着髋关节镜检查后患者报告的心理社会健康结果更好。
Higher preoperative patient expectations predict better patient-reported psychosocial health outcomes after hip arthroscopy.
作者信息
Henry Leah E, Leon Brandon, Ventimiglia Dominic J, McCurdy Michael A, Dabic Stefan, Leong Natalie L, Packer Jonathan D, Henn R Frank, Meredith Sean J
机构信息
Department of Orthopaedic Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.
出版信息
J Orthop. 2024 Nov 19;64:23-28. doi: 10.1016/j.jor.2024.11.010. eCollection 2025 Jun.
INTRODUCTION
Preoperative expectations are a determinant of patient-reported outcomes (PROs) within several orthopaedic subspecialties. However, the impact on outcomes after hip arthroscopy is unclear. The aim of this study was to explore the relationship between preoperative patient expectations and PROs after hip arthroscopy.
METHODS
Patients who underwent hip arthroscopy at a single institution were included. Patient expectations were measured preoperatively using the Musculoskeletal Outcomes Data Evaluation and Management System (MODEMS) expectations domain. Patient-Reported Outcomes Measurement Information System (PROMIS) domains, a numeric pain scale (NPS), and the Marx activity rating scale (MARS) were assessed 2 years postoperatively. Spearman's coefficient was used to assess the correlation between preoperative expectations and 2-year PROs. Linear regression was used to ascertain the effect of preoperative expectations on 2-year PROs.
RESULTS
105 patients were included, and 78 (74 %) completed 2-year follow-up. The mean (SD) preoperative expectations score was 88.3 (15.3). Higher expectations correlated with better postoperative fatigue, anxiety, depression, pain, and activity levels, as well as more improvement in fatigue, pain, and activity. Expectations scores were higher for patients who achieved minimal clinically important difference (MCID) for PROMIS Fatigue (92.6 vs 82.0, p = .003) and MARS activity (95.3 vs 86.2, p = .014). When controlling for possible confounders, higher expectations independently predicted better postoperative PROMIS Fatigue (β = -0.26, SE = 7.23), Social Satisfaction (β = 0.24, SE = 0.09), and Anxiety (β = -0.24, SE = 0.08).
CONCLUSION
Higher preoperative expectations are an independent predictor of better psychosocial outcomes 2 years after hip arthroscopy. Setting positive expectations preoperatively may be important for enhancing psychosocial health postoperatively.
引言
术前期望是多个骨科亚专业中患者报告结局（PROs）的一个决定因素。然而，其对髋关节镜检查术后结局的影响尚不清楚。本研究的目的是探讨术前患者期望与髋关节镜检查术后PROs之间的关系。
方法
纳入在单一机构接受髋关节镜检查的患者。术前使用肌肉骨骼结局数据评估与管理系统（MODEMS）期望领域来测量患者期望。术后2年评估患者报告结局测量信息系统（PROMIS）领域、数字疼痛量表（NPS）和马克思活动评分量表（MARS）。采用Spearman系数评估术前期望与2年PROs之间的相关性。使用线性回归确定术前期望对2年PROs的影响。
结果
纳入105例患者，78例（74%）完成了2年随访。术前期望评分的均值（标准差）为88.3（15.3）。更高的期望与更好的术后疲劳、焦虑、抑郁、疼痛和活动水平相关，以及在疲劳、疼痛和活动方面有更大改善。对于在PROMIS疲劳（92.6对82.0，p = 0.003）和MARS活动（95.3对86.2，p = 0.014）方面达到最小临床重要差异（MCID）的患者，期望评分更高。在控制可能的混杂因素后，更高的期望独立预测了更好的术后PROMIS疲劳（β = -0.26，标准误 = 7.23）、社会满意度（β = 0.24，标准误 = 0.09）和焦虑（β = -0.24，标准误 = 0.08）。
结论
更高的术前期望是髋关节镜检查术后2年更好的心理社会结局的独立预测因素。术前设定积极期望可能对增强术后心理社会健康很重要。
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