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Psychologic distress reduces preoperative self-assessment scores in femoroacetabular impingement patients.
- Source :
-
Clinical orthopaedics and related research [Clin Orthop Relat Res] 2014 Jun; Vol. 472 (6), pp. 1886-92. Date of Electronic Publication: 2014 Feb 27. - Publication Year :
- 2014
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Abstract
- Background: In several areas of orthopaedics, including spine and upper extremity surgery, patients with greater levels of psychologic distress report worse self-assessments of pain and function than patients who are not distressed. This effect can lead to lower than expected baseline scores on common patient-reported outcome scales, even those not traditionally considered to have a psychologic component.<br />Questions/purposes: The purposes of this study were to determine (1) the association of psychologic distress and baseline modified Harris hip scores and Hip Outcome Scores in patients undergoing hip arthroscopy; and (2) whether psychologic distress would remain a significant negative predictor of baseline hip scores when other clinical variables such as age, sex, BMI, smoking status, and American Society of Anesthesiologists (ASA) classification were controlled.<br />Methods: One hundred forty-seven patients at one center were prospectively enrolled when they scheduled hip arthroscopy to treat painful femoroacetabular impingement. Before surgery, psychologic distress was quantified using the Distress Risk Assessment Method questionnaire. Patients also completed baseline self-assessments of hip pain and function including the modified Harris hip score and the Hip Outcome Score. Age, sex, BMI, smoking status, and ASA classification were recorded for each patient. Bivariate correlations and multivariate regression models were used to assess the effect of psychologic distress on patient self-assessment of hip pain and function.<br />Results: Patients with distress reported significantly lower baseline modified Harris hip scores (58 versus 67, p = 0.001), Hip Outcome Score-Activities of Daily Living scores (62 versus 72, p = 0.002), and Hip Outcome Score-Sports scores (36 versus 47, p = 0.02). Distress remained significantly associated with lower baseline modified Harris hip (p = 0.006), Hip Outcome Score-Activities of Daily Living (p = 0.005), and Hip Outcome Score-Sports scores (p = 0.017) when age, sex, BMI, smoking status, and ASA classification were controlled for in the multivariate model.<br />Conclusions: Practitioners should recognize that psychologic distress has a negative correlation with baseline patient self-assessment using the modified Harris hip score and the Hip Outcome Scores, scales not previously described to correlate with psychologic distress. Longitudinal followup is warranted to clarify the relationship between distress and self-perceived disability and the effect of distress on postoperative outcomes in patients having hip arthroscopy.<br />Level of Evidence: Level III, prognostic study. See the Instructions for Authors for a complete description of levels of evidence.
- Subjects :
- Activities of Daily Living
Adolescent
Adult
Aged
Arthroscopy
Female
Femoracetabular Impingement physiopathology
Femoracetabular Impingement surgery
Hip Joint physiopathology
Hip Joint surgery
Humans
Least-Squares Analysis
Linear Models
Male
Middle Aged
Multivariate Analysis
Pain Measurement
Preoperative Period
Prospective Studies
Psychiatric Status Rating Scales
Risk Factors
Stress, Psychological diagnosis
Young Adult
Femoracetabular Impingement diagnosis
Femoracetabular Impingement psychology
Self-Assessment
Stress, Psychological psychology
Surveys and Questionnaires
Subjects
Details
- Language :
- English
- ISSN :
- 1528-1132
- Volume :
- 472
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Clinical orthopaedics and related research
- Publication Type :
- Academic Journal
- Accession number :
- 24574122
- Full Text :
- https://doi.org/10.1007/s11999-014-3531-z