Predicting outcomes of total joint arthroplasty using the distress and risk assessment method.
Arthroplasty, Replacement, Hip
/ psychology
Arthroplasty, Replacement, Knee
/ psychology
Humans
Joint Diseases
/ psychology
Mental Health
Prognosis
Prospective Studies
Range of Motion, Articular
/ physiology
Risk Assessment
/ methods
Stress, Psychological
/ diagnosis
Surveys and Questionnaires
Treatment Outcome
Hip
knee
outcomes
psychological distress
risk assessment
total joint arthroplasty
Journal
Hip international : the journal of clinical and experimental research on hip pathology and therapy
ISSN: 1724-6067
Titre abrégé: Hip Int
Pays: United States
ID NLM: 9200413
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
pubmed:
5
4
2019
medline:
21
10
2020
entrez:
5
4
2019
Statut:
ppublish
Résumé
Psychological distress is presumed to be an important factor that can adversely impact the outcome of orthopaedic procedures. The Distress and Risk Assessment Method (DRAM) is an evaluation tool which assesses psychological distress in patients with low back pain. The purpose of this prospective study was to assess the influence of preoperative psychological distress, as determined by the DRAM score, on the functional outcomes of total joint arthroplasty (TJA). A prospective study of 61 TJAs was performed at a single institution. The DRAM questionnaire and a variety of functional measures (12-Item Short Form Health Survey [SF-12], visual analogue scale [VAS], Oxford Hip Score [OHS], Oxford Knee Score [OKS], and Oswestry Disability Questionnaire [ODQ]) were administered to the patient at baseline, 1 month, and 6 months postoperatively. Mixed model regressions and Mann-Whitney tests were utilised to evaluate the relationship of the DRAM score with functional outcomes. The summed quantitative DRAM score was predictive of functional outcomes. With each 1 point increase in psychological distress, VAS pain increased by 0.023 ( Psychological distress was associated with decreased baseline mental health and function in the early postoperative period, which has important implications for bundled payments. However, patients with psychological distress still demonstrated functional improvements and TJA should thus not be contraindicated in these patients.
Sections du résumé
BACKGROUND
BACKGROUND
Psychological distress is presumed to be an important factor that can adversely impact the outcome of orthopaedic procedures. The Distress and Risk Assessment Method (DRAM) is an evaluation tool which assesses psychological distress in patients with low back pain. The purpose of this prospective study was to assess the influence of preoperative psychological distress, as determined by the DRAM score, on the functional outcomes of total joint arthroplasty (TJA).
MATERIALS AND METHODS
METHODS
A prospective study of 61 TJAs was performed at a single institution. The DRAM questionnaire and a variety of functional measures (12-Item Short Form Health Survey [SF-12], visual analogue scale [VAS], Oxford Hip Score [OHS], Oxford Knee Score [OKS], and Oswestry Disability Questionnaire [ODQ]) were administered to the patient at baseline, 1 month, and 6 months postoperatively. Mixed model regressions and Mann-Whitney tests were utilised to evaluate the relationship of the DRAM score with functional outcomes.
RESULTS
RESULTS
The summed quantitative DRAM score was predictive of functional outcomes. With each 1 point increase in psychological distress, VAS pain increased by 0.023 (
DISCUSSION
CONCLUSIONS
Psychological distress was associated with decreased baseline mental health and function in the early postoperative period, which has important implications for bundled payments. However, patients with psychological distress still demonstrated functional improvements and TJA should thus not be contraindicated in these patients.
Identifiants
pubmed: 30945562
doi: 10.1177/1120700019836403
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM