Authors: Michael Q Potter James D Wylie Patrick E Greis Robert T Burks Robert Z Tashjian
Publish Date: 2014/07/31
Volume: 472, Issue: 12, Pages: 3926-3932
Abstract
In many areas of orthopaedics patients with greater levels of psychological distress report inferior selfassessments of pain and function This effect can lead to lowerthanexpected baseline scores on common patientreported outcome scales even those not traditionally considered to have a psychological componentThis study attempts to answer the following questions 1 Are higher levels of psychological distress associated with clinically important differences in baseline scores on the VAS for pain the Simple Shoulder Test and the American Shoulder and Elbow Surgeons score in patients undergoing arthroscopic rotator cuff repair 2 Does psychological distress remain a negative predictor of baseline shoulder scores when other clinical variables are controlledEightyfive patients with fullthickness rotator cuff tears were prospectively enrolled Psychological distress was quantified using the Distress Risk Assessment Method questionnaire Patients completed baseline selfassessments including the VAS for pain the Simple Shoulder Test and the American Shoulder and Elbow Surgeons score Age sex BMI smoking status American Society of Anesthesiologists classification tear size and tear retraction were recorded for each patient Bivariate correlations and multivariate regression models were used to assess the effect of psychological distress on patient selfassessment of shoulder pain and functionDistressed patients reported higher baseline VAS scores 67 95 CI 44–90 versus 29 95 CI 23–36 p = 0001 and lower baseline Simple Shoulder Test 37 95 CI 29–45 versus 57 95 CI 50–64 p = 0001 and American Shoulder and Elbow Surgeons scores 39 95 CI 34–45 versus 58 95 CI 53–63 p 0001 Distress remained associated with higher VAS scores p = 0001 and lower Simple Shoulder Test p 0001 and American Shoulder and Elbow Surgeons scores p 0001 when age sex BMI American Society of Anesthesiologists classification smoking status tear size and tear retraction were controlledHigher levels of psychological distress are associated with inferior baseline patient selfassessment of shoulder pain and function using the VAS the Simple Shoulder Test and the American Shoulder and Elbow Surgeons score Longitudinal followup is warranted to clarify the relationship between distress and selfperceived disability and the effect of distress on postoperative outcomes after arthroscopic rotator cuff repairEach author certifies that he or she or a member of his or her immediate family has no funding or commercial associations eg consultancies stock ownership equity interest patent/licensing arrangements etc that might pose a conflict of interest in connection with the submitted articleEach author certifies that his or her institution approved the human protocol for this investigation that all investigations were conducted in conformity with ethical principles of research and that informed consent for participation in the study was obtained
Keywords: