Leon Brandon, Kaveeshwar Samir, Kevas Yanni, Rivkin Daniel, Schneider Matheus B, Henry Leah E, Honig Evan L, McCurdy Michael A, Pensy Raymond A, Langhammer Christopher G, Henn Ralph Frank
Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD.
J Hand Surg Glob Online. 2025 Jun 4;7(4):100763. doi: 10.1016/j.jhsg.2025.100763. eCollection 2025 Jul.
The purpose of this paper was to use validated instruments to identify if there is a relationship between preoperative expectations and patient-reported outcomes (PROs) in patients undergoing hand and wrist surgery. We hypothesized that preoperative expectations would be predictive of 2-year PROs in hand and wrist surgery patients.
In total, 253 patients who underwent hand and wrist surgery were enrolled in a prospective orthopedic registry. The Musculoskeletal Outcomes Data Evaluation and Management System was used to measure preoperative expectations. At both baseline and 2 years after surgery, patients completed multiple questionnaires with multiple PROs, including six domains of the PROs measurement information system (PROMIS) and the Brief Michigan Hand Questionnaire.
Overall, patients undergoing hand and wrist surgery had high expectations. Worse preoperative expectations were significantly associated with smoking, worker's compensation or other legal claim, a greater number of prior surgeries, and worse baseline PROMIS physical function, fatigue, and anxiety ( < .05). Bivariate analysis indicated that greater preoperative expectations were associated with better 2-year PROMIS physical function, PROMIS pain interference, PROMIS fatigue, PROMIS depression, numeric pain scale, surgical satisfaction questionnaire scores, met expectations, and the Brief Michigan Hand Questionnaire ( < .05). Multivariable analysis controlling for confounding variables revealed that preoperative expectations were not independently predictive of any 2-year PROs.
Patients' preoperative expectations are associated with, but not independently predictive of, 2-year patient-reported outcomes.
TYPE/OF STUDY/LEVEL OF EVIDENCE: Prognostic IIB.
本文旨在使用经过验证的工具，确定接受手部和腕部手术的患者术前期望与患者报告结局（PROs）之间是否存在关联。我们假设术前期望可预测手部和腕部手术患者的2年PROs。
共有253例接受手部和腕部手术的患者被纳入一个前瞻性骨科登记系统。使用肌肉骨骼结局数据评估和管理系统来测量术前期望。在基线和术后2年时，患者均完成了多项包含多个PROs的问卷，包括PROs测量信息系统（PROMIS）的六个领域以及密歇根手部简易问卷。
总体而言，接受手部和腕部手术的患者期望较高。术前期望较差与吸烟、工伤赔偿或其他法律索赔、既往手术次数较多以及基线时PROMIS身体功能、疲劳和焦虑较差显著相关（P<0.05）。双变量分析表明，术前期望较高与2年时较好的PROMIS身体功能、PROMIS疼痛干扰、PROMIS疲劳、PROMIS抑郁、数字疼痛量表、手术满意度问卷得分、达到期望以及密歇根手部简易问卷相关（P<0.05）。控制混杂变量的多变量分析显示，术前期望并不能独立预测任何2年的PROs。
患者的术前期望与2年患者报告结局相关，但不能独立预测。
研究类型/证据水平：预后IIB级。
