The Psychological Impact of Adult Traumatic Brachial Plexus Injury.

IF 1.8 Q2 ORTHOPEDICS

HAND Pub Date : 2024-12-11 DOI:10.1177/15589447241302357

Sivaram Emani, Rohit Garg, Bassem Elhassan, Jonathan Winograd, Dafang Zhang

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引用次数: 0

Abstract

Background: Adult traumatic brachial plexus injuries (BPIs) present a significant medical challenge, potentially leading to life-altering consequences for patients' upper extremity pain and function. However, the psychological impact on patients has not been extensively studied.

Methods: Adult patients with traumatic BPIs treated at 2 tertiary referral centers in the United States from 2015 to 2019 were retrospectively identified. This cohort of 84 patients was targeted for prospective interviews, and 44 patients (52%) responded. Validated measures including the posttrumatic stress disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition (PCL-5), Decision Regret Scale, Patient-Reported Outcome Measurement Information System (PROMIS) Pain Intensity, PROMIS Pain Interference, PROMIS Upper Extremity, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) were obtained through telephone-based interviews. Additional data were collected through electronic medical record review.

Results: On average, patients experience low post-traumatic stress (median score 6, interquartile range [IQR] 3-20) and decision regret (median score 5, IQR 0-22.5). However, a notable fraction (18%) of patients met the clinical threshold for PTSD. Significant correlations were observed between PCL-5 scores and worse PROMIS Pain Intensity, PROMIS Pain Interference, PROMIS Upper Extremity, and QuickDASH. Decision regret scores correlated with worse PROMIS Upper Extremity and QuickDASH.

Conclusions: While the overall incidence of PTSD and treatment decision regret after adult traumatic BPI is low, clinical PTSD was found in a significant percentage of patients associated with pain and functional impairment. This study highlights the importance of understanding and addressing the psychological burden of traumatic BPI.

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成人外伤性臂丛神经损伤的心理影响。

背景：成人创伤性臂丛神经损伤（BPIs）是一个重大的医学挑战，可能导致患者上肢疼痛和功能改变生活的后果。然而，对患者的心理影响尚未得到广泛研究。方法：回顾性分析2015年至2019年在美国2个三级转诊中心治疗的创伤性bp成年患者。该队列有84名患者，目标是进行前瞻性访谈，44名患者（52%）回应。通过电话访谈获得了经验证的测量方法，包括精神障碍诊断与统计手册第五版（PCL-5）、决策后悔量表、患者报告结果测量信息系统（PROMIS）疼痛强度、PROMIS疼痛干扰、PROMIS上肢和臂、肩、手的快速残疾（QuickDASH）。通过电子病历审查收集了其他数据。结果：平均而言，患者经历低创伤后应激（中位数得分6，四分位数范围[IQR] 3-20）和决策后悔（中位数得分5，IQR 0-22.5）。然而，有显著比例（18%）的患者达到了PTSD的临床阈值。PCL-5评分与较差的PROMIS疼痛强度、PROMIS疼痛干扰、PROMIS上肢和QuickDASH之间存在显著相关。决策后悔得分与较差的PROMIS上肢和QuickDASH相关。结论：虽然成人创伤性BPI后PTSD和治疗决策后悔的总体发生率较低，但临床PTSD在与疼痛和功能障碍相关的患者中占很大比例。本研究强调了理解和处理创伤性脑损伤的心理负担的重要性。

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

HAND Medicine-Surgery

CiteScore

3.30

自引率

0.00%

发文量

209

期刊介绍： HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.