The PROMIS-10 Global Mental Health T-Score: An Independent Predictor of In-Hospital Recovery Following a Total Hip Arthroplasty.

IF 2.6 2区医学 Q1 ORTHOPEDICS

Journal of the American Academy of Orthopaedic Surgeons Pub Date : 2024-12-03 DOI:10.5435/JAAOS-D-24-00430

Regina O Kostyun, Daniel K Witmer, Peter Lucchio, Matthew J Solomito

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Abstract

Background: Currently, few investigations explore the connection between global mental health and recovery following total hip arthroplasty (THA). The increased utilization of patient-reported outcomes tools provides an opportunity to assess a patient's mental health without undue survey burden. The purpose of this study was to explore how mental health is associated with a patient's immediate in-hospital recovery regardless of a formally diagnosed mental illness.

Methods: This retrospective study consisted of patients undergoing elective primary THA. Patients were grouped by both their PROMIS 10 Global Mental Health T-score (MHT) and whether they had a formally diagnosed mental illness. The resulting four patient groups were compared using multivariate regression analyses to determine differences in in-hospital pain reporting, opioid consumption, and discharge disposition.

Results: One thousand four hundred and twenty nine patients were included in this study. MHT was an independent predictor of pain reporting at discharge (P < 0.001) and inpatient opioid consumption (P = 0.002). Regardless of the presence of mental illness, patients self-reporting poor mental health (MHT<40) reported higher pain levels, consumed more opioids, and were more likely to be discharged to a facility than those with an MHT >50.

Conclusion: Mental illness was not an independent predictor of immediate postoperative outcomes, but self-reported global mental health assessed using the MHT was. Therefore, surgeons should be aware of their patient's global mental health status before surgery because it is associated with in-hospital recovery following THA.

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promise -10全球心理健康t评分：全髋关节置换术后住院康复的独立预测因子

背景：目前，很少有研究探讨全髋关节置换术（THA）后全球心理健康与康复之间的关系。患者报告结果工具的使用增加，为评估患者的心理健康提供了机会，而不会造成不必要的调查负担。本研究的目的是探讨心理健康与病人的即时住院康复之间的关系，而不管是否被正式诊断为精神疾病。方法：本回顾性研究包括接受选择性原发性THA手术的患者。患者根据他们的PROMIS 10全球心理健康t评分（MHT）和他们是否有正式诊断的精神疾病进行分组。采用多变量回归分析对四组患者进行比较，以确定住院疼痛报告、阿片类药物使用和出院处置方面的差异。结果：本研究共纳入1429例患者。MHT是出院时疼痛报告（P < 0.001）和住院阿片类药物消耗（P = 0.002）的独立预测因子。无论是否存在精神疾病，患者自我报告的精神健康状况不佳（MHT50）。结论：精神疾病不是术后直接预后的独立预测因子，但使用MHT评估的自我报告的整体心理健康是。因此，外科医生在手术前应了解患者的整体心理健康状况，因为这与THA术后住院康复有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American Academy of Orthopaedic Surgeons 医学-整形外科

CiteScore

6.10

自引率

6.20%

发文量

529

审稿时长

4-8 weeks

期刊介绍： The Journal of the American Academy of Orthopaedic Surgeons was established in the fall of 1993 by the Academy in response to its membership’s demand for a clinical review journal. Two issues were published the first year, followed by six issues yearly from 1994 through 2004. In September 2005, JAAOS began publishing monthly issues. Each issue includes richly illustrated peer-reviewed articles focused on clinical diagnosis and management. Special features in each issue provide commentary on developments in pharmacotherapeutics, materials and techniques, and computer applications.