术前预期不能独立预测手部和手腕手术后两年患者报告的结果

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2025-06-04 DOI:10.1016/j.jhsg.2025.100763

Brandon Leon MD , Samir Kaveeshwar MD , Yanni Kevas MD , Daniel Rivkin BS , Matheus B. Schneider MD , Leah E. Henry MD , Evan L. Honig MD , Michael A. McCurdy MD , Raymond A. Pensy MD , Christopher G. Langhammer MD , Ralph Frank Henn III MD

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引用次数: 0

摘要

目的本文的目的是使用经过验证的仪器来确定在手腕部手术患者的术前预期与患者报告的预后（PROs）之间是否存在关系。我们假设术前预期可以预测手部和腕部手术患者2年的PROs。方法共纳入253例手部和腕部手术患者，纳入前瞻性骨科登记。肌肉骨骼结果数据评估和管理系统用于测量术前预期。在基线和术后2年，患者完成了包含多个PROs的问卷，包括PROs测量信息系统（PROMIS）的6个领域和简短的Michigan Hand问卷。结果总的来说，接受手和手腕手术的患者有很高的期望。较差的术前预期与吸烟、工伤赔偿或其他法律索赔、先前手术次数较多、较差的基线PROMIS身体功能、疲劳和焦虑(P <；. 05)。双变量分析表明，术前期望值越高，2年PROMIS身体功能、疼痛干扰、疲劳、抑郁、数字疼痛量表、手术满意度问卷得分、期望值满足程度和简短密歇根手问卷(P <；. 05)。控制混杂变量的多变量分析显示，术前预期并不能独立预测任何2年的PROs。结论：患者的术前预期与患者报告的2年预后相关，但不能独立预测。类型/研究/证据水平预后IIB。

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Preoperative Expectations Do Not Independently Predict Two-Year Patient-Reported Outcomes Following Hand and Wrist Surgery

Purpose

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.

Methods

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.

Results

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 (P < .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 (P < .05). Multivariable analysis controlling for confounding variables revealed that preoperative expectations were not independently predictive of any 2-year PROs.