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Abstract：
The aim of this study was to evaluate the prognostic value of preoperative patient-reported outcomes as predictors of functional improvement following ligament reconstruction tendon interposition. We hypothesized that high levels of preoperative pain interference (PI) and upper-extremity disability are associated with lower magnitudes of functional improvement ≥1 year after surgery on the shortened version of the Disabilities of the Arm, Shoulder, and Hand (QuickDASH) (primary outcome) and Patient-Reported Outcomes Measurement Information System Upper Extremity (UE) Computer Adaptive Test (CAT) (UE CAT) v1.2 (secondary outcome).
Adult patients who underwent ligament reconstruction tendon interposition between February 2014 and April 2018 at an academic tertiary institution were considered for inclusion in this longitudinal cohort study. Patient-reported outcomes were collected at baseline and ≥1 year after surgery. Univariate and multivariable linear regression analyses were performed to identify factors associated with the magnitude of functional improvement on the QuickDASH and UE CAT.
Among 93 included participants, the mean age was 61 ± 7 years, and 75 (81%) were women. At 2.5 ± 1.0 years after surgery, the QuickDASH and UE CAT improved by a mean of 24.5 ± 20.9 and 9.9 ± 10.7 points, respectively. In the primary multivariable model, a greater preoperative QuickDASH (indicative of lower function; coefficient, 0.8; 95% confidence interval [CI], 0.6 to 0.9) and lower preoperative Performance of Patient-Reported Outcomes Measurement Information System PI CAT (eg, less pain interference; coefficient, -0.7; 95% CI, -1.2 to -0.2) were associated with greater QuickDASH improvement independent of potential confounders. In the secondary multivariable model, lower preoperative UE CAT (indicative of worse function; coefficient, -0.9; 95% CI, -1.1 to -0.7) and lower preoperative Patient-Reported Outcomes Measurement Information System PI CAT (coefficient, -0.3; 95% CI, -0.6 to -0.1) were associated with greater UE CAT improvement.
Preoperative patient-reported outcomes may be useful in understanding the degree of improvement that certain patient populations can expect from ligament reconstruction tendon interposition. Those with lower baseline (preoperative) upper-extremity function and PI are expected to derive the greatest functional improvement in the midterm.
Prognostic IV.
Adult patients who underwent ligament reconstruction tendon interposition between February 2014 and April 2018 at an academic tertiary institution were considered for inclusion in this longitudinal cohort study. Patient-reported outcomes were collected at baseline and ≥1 year after surgery. Univariate and multivariable linear regression analyses were performed to identify factors associated with the magnitude of functional improvement on the QuickDASH and UE CAT.
Among 93 included participants, the mean age was 61 ± 7 years, and 75 (81%) were women. At 2.5 ± 1.0 years after surgery, the QuickDASH and UE CAT improved by a mean of 24.5 ± 20.9 and 9.9 ± 10.7 points, respectively. In the primary multivariable model, a greater preoperative QuickDASH (indicative of lower function; coefficient, 0.8; 95% confidence interval [CI], 0.6 to 0.9) and lower preoperative Performance of Patient-Reported Outcomes Measurement Information System PI CAT (eg, less pain interference; coefficient, -0.7; 95% CI, -1.2 to -0.2) were associated with greater QuickDASH improvement independent of potential confounders. In the secondary multivariable model, lower preoperative UE CAT (indicative of worse function; coefficient, -0.9; 95% CI, -1.1 to -0.7) and lower preoperative Patient-Reported Outcomes Measurement Information System PI CAT (coefficient, -0.3; 95% CI, -0.6 to -0.1) were associated with greater UE CAT improvement.
Preoperative patient-reported outcomes may be useful in understanding the degree of improvement that certain patient populations can expect from ligament reconstruction tendon interposition. Those with lower baseline (preoperative) upper-extremity function and PI are expected to derive the greatest functional improvement in the midterm.
Prognostic IV.
摘要：
目的：本研究的目的是评估术前患者报告的结果作为韧带重建肌腱插入术后功能改善的预测因子的预后价值。我们假设高水平的术前疼痛干扰（PI）和上肢残疾与手术后1年以上的功能改善幅度较低相关，肩膀,和手（QuickDASH）（主要结果）和患者报告的结果测量信息系统上肢（UE）计算机自适应测试（CAT）（UECAT）v1.2（次要结果）。
方法：在2014年2月至2018年4月期间在某学术大专院校接受韧带重建肌腱插入术的成年患者考虑纳入本纵向队列研究。在基线和手术后≥1年收集患者报告的结果。进行单变量和多变量线性回归分析以确定与QuickDASH和UECAT上的功能改善幅度相关的因素。
结果：在93名参与者中，平均年龄为61±7岁，75（81%）为女性。手术后2.5±1.0年，QuickDASH和UECAT平均提高了24.5±20.9和9.9±10.7点，分别。在主要的多变量模型中，术前QuickDASH较大(指示功能较低；系数，0.8；95%置信区间[CI]，0.6至0.9）和较低的患者报告结果测量信息系统PICAT的术前性能（例如，疼痛干扰较少；系数，-0.7；95%CI，-1.2至-0.2）与更大的QuickDASH改善相关，与潜在的混杂因素无关。在二级多变量模型中，术前UECAT较低(表明功能较差；系数，-0.9；95%CI，-1.1至-0.7）和较低的术前患者报告结果测量信息系统PICAT（系数，-0.3；95%CI，-0.6至-0.1）与更大的UECAT改善相关。
结论：术前患者报告的结果可能有助于了解某些患者人群对韧带重建肌腱插入术的期望改善程度。那些基线（术前）上肢功能和PI较低的患者有望在中期获得最大的功能改善。
方法：预后IV.
方法：在2014年2月至2018年4月期间在某学术大专院校接受韧带重建肌腱插入术的成年患者考虑纳入本纵向队列研究。在基线和手术后≥1年收集患者报告的结果。进行单变量和多变量线性回归分析以确定与QuickDASH和UECAT上的功能改善幅度相关的因素。
结果：在93名参与者中，平均年龄为61±7岁，75（81%）为女性。手术后2.5±1.0年，QuickDASH和UECAT平均提高了24.5±20.9和9.9±10.7点，分别。在主要的多变量模型中，术前QuickDASH较大(指示功能较低；系数，0.8；95%置信区间[CI]，0.6至0.9）和较低的患者报告结果测量信息系统PICAT的术前性能（例如，疼痛干扰较少；系数，-0.7；95%CI，-1.2至-0.2）与更大的QuickDASH改善相关，与潜在的混杂因素无关。在二级多变量模型中，术前UECAT较低(表明功能较差；系数，-0.9；95%CI，-1.1至-0.7）和较低的术前患者报告结果测量信息系统PICAT（系数，-0.3；95%CI，-0.6至-0.1）与更大的UECAT改善相关。
结论：术前患者报告的结果可能有助于了解某些患者人群对韧带重建肌腱插入术的期望改善程度。那些基线（术前）上肢功能和PI较低的患者有望在中期获得最大的功能改善。
方法：预后IV.
