High Pain Catastrophizing Scale predicts lower patient-reported outcome measures in the foot and ankle patient

Background: A patient’s healthcare experience can be modulated by their understanding of their pre-operative disability along with their overall coping strategy. It is hypothesized that patient’s catastrophization and expectation on what they deem to be a successful surgery can affect their outcome. Methods: This current study prospectively assessed a consecutive cohort of patients undergoing foot and ankle reconstruction to describe the relationship between Pain Catastrophizing Scale (PCS) and patient-reported outcomes: SF-12 & FAOS. The PCS has a total score and three subcategories which are rumination, helplessness and magnification. Results: Forty-six patients were found to be eligible in the study with an average age of 54.7±14.4 years-old, a majority female (65%), a minority employed at the pre-operative visit (41%) and with an average BMI of 26.2±5.56. Looking at the FAOS Pain domain, it correlated significantly with the PCS Rumination and Helplessness subcategories. The FAOS Activity of Daily Living domain showed significant correlation with the PCS Rumination and Helplessness subcategories. The FAOS Quality of life domain was also statistically significant for the PCS Rumination and Helplessness subcategories. We found that the mental domain of the SF-12 had a statistically significant effect when compared to the Rumination (p=0.01) and Helplessness (p=0.001) subcategories.Conclusion: This study showed a significant association between an increase preoperative PCS and a worse one-year outcome looking at the FAOS domains. As such, in elective foot and ankle surgery, catastrophization should be screened for and potentially modulated pre-operatively to improve patient operative outcomes.