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1.
Susana Núñez-Pereira Alba Vila-Casademunt Montse Domingo-Sàbat Juan Bagó Emre R. Acaroglu Ahmet Alanay Ibrahim Obeid Francisco Javier Sánchez Pérez-Grueso Frank Kleinstück Ferran Pellisé 《The spine journal》2018,18(6):926-934
Background Context
Revision surgery represents a major event for patients undergoing adult spinal deformity (ASD) surgery. Previous reports suggest that ASD surgery has minimal or no impact on health-related-quality of life (HRQOL) outcomes.Purpose
The present study aims to investigate the impact of early reoperations within the first year on HRQOL and on the likelihood of reaching the minimally clinically important difference (MCID) after ASD surgery.Design
This is a retrospective analysis of prospectively collected data from consecutive surgically treated adult deformity surgery patients included in a multicenter, international database.Patient Sample
The present study included 280 patients from a multicenter international prospective database.Outcome Measure
Oswestry Disability Index (ODI), Short Form-36 (SF-36), Scoliosis Research Society-22 (SRS-22), MCID were evaluated in this work.Methods
Consecutive surgical patients with ASD recruited prospectively in six different centers from four countries with a minimum 2-year follow-up were stratified into two groups: R (revision surgery within the first year) and NR (no revision). Health-related-quality of life (ODI, SF-36, SRS-22) was assessed and compared at 6-month, 1-year, and 2-year follow-up stages. Statistical analysis included chi-square tests, Student t tests, and linear mixed models.Results
Forty-three patients (R Group) received 46 revision surgeries. Nineteen patients (41.3%) had implant-related complications, 9 patients (19.6%) had deep surgical site infections, 9 patients (19.6%) had proximal junctional kyphosis, 3 patients (6.5%) had hematoma, and 6 patients (13%) had other complications. Baseline characteristics differed between groups.At 6 months, all HRQOL scores improved in both groups, except in the SF-36 Mental Component Summary and SRS-22 mental health domain in the R Group. At 1 year, ODI and SRS-22 improvement was significantly greater in the NR Group, exceeding the reported MCID. At the 2-year follow-up, ODI, SRS-22, SF-36 MCS, and SF-36 PCS improvement was similar in both groups. However, postoperative change was only above the MCID for SF-36 PCS, ODI, and SRS-22 in the NR Group.Conclusions
Early unanticipated revision surgery has a negative impact on mental health at 6 months and reduces the chances of reaching an MCID improvement in SRS-22, SF-36 PCS, and ODI at the 2-year follow-up. 相似文献2.
Selcen Yuksel Selim Ayhan Vugar Nabiyev Montse Domingo-Sabat Alba Vila-Casademunt Ibrahim Obeid Francisco Sanchez Perez-Grueso Emre Acaroglu 《The spine journal》2019,19(1):71-78
BACKGROUND CONTEXT
Health-related quality of life (HRQOL) parameters have been shown to be reliable and valid in patients with adult spinal deformity (ASD). Minimum clinically important difference (MCID) has become increasingly important to clinicians in evaluating patients with a threshold of improvement that is clinically relevant.PURPOSE
To calculate MCID and minimum detectable change (MDC) values of total scores of the Core Outcome Measures Index (COMI), Oswestry Disability Index (ODI), Physical Component Summary (PCS), Mental Component Summary (MCS) of the Short Form 36 (SF-36), and Scoliosis Research Society 22R (SRS-22R) in surgically and nonsurgically treated ASD patients who have completed an anchor question at pretreatment and 1-year follow-up.STUDY DESIGN/SETTING
Prospective cohort.PATIENT SAMPLE
Surgical and nonsurgical patients from a multicenter ASD database.OUTCOME MEASURES
Self-reported HRQOL measures (COMI, ODI, SF-36, SRS-22R, and anchor question).METHODS
A total of 185 surgical and 86 nonsurgical patients from a multicenter ASD database who completed pretreatment and 1-year follow-up HRQOL scales and the anchor question at the first year follow-up were included. The anchor question was used to determine MCID for each HRQOL measure. MCIDs were calculated by an anchor-based method using latent class analysis (LCA) and MDCs by a distribution-based method.RESULTS
All differences between means of baseline and first year postoperative total score measures for all scales demonstrated statistically significant improvements in the overall population as well as the surgically treated patients but not in the nonsurgical group. The calculated MDC and MCID values of HRQOL parameters in the entire study population were 1.34 and 2.62 for COMI, 10.65 and 14.31 for ODI, 6.09 and 7.33 for SF-36 PCS, 6.14 and 4.37 for SF-36 MCS, and 0.42 and 0.71 for SRS-22R. The calculated MCID values for surgical and non-surgical treatment groups were 2.76 versus 1.20 for COMI, 14.96 versus 2.45 for ODI, 7.83 versus 2.15 for SF-36 PCS, 5.14 versus 2.03 for SF-36 MCS, and 0.94 versus 0.11 for SRS-22R; the MDC values for surgical and nonsurgical treatment groups were 1.22 versus 1.51 for COMI, 10.27 versus 9.45 for ODI, 5.16 versus 6.77 for SF-36 PCS, 6.05 versus 5.67 for SF-36 MCS, and 0.38 versus 0.43 for SRS-22R.CONCLUSIONS
This study has demonstrated that MCID calculations for the HRQOL scales in ASD using LCA yield values comparable to other studies that had used different methodologies. The most important finding was the significantly different MCIDs for COMI, ODI, SF-36 PCS and SRS-22 in the surgically and nonsurgically treated cohorts. This finding suggests that a universal MCID value, inherent to a specific HRQOL for an entire cohort of ASD may not exist. Use of different MCIDs for surgical and nonsurgical patients may be warranted. 相似文献3.
Justin K. Scheer Malla Keefe Virginie Lafage Michael P. Kelly Shay Bess Douglas C. Burton Robert A. Hart Amit Jain Baron S. Lonner Themistocles S. Protopsaltis Richard Hostin Christopher I. Shaffrey Justin S. Smith Frank Schwab Christopher P. Ames 《The spine journal》2017,17(10):1397-1405
Background Context
Current metrics to assess patients' health-related quality of life (HRQOL) may not reflect a true change in the patients' specific perception of what is most important to them.Purpose
This study aimed to describe the initial experience of a Patient Generated Index (PGI) in which patients create their own outcome domains.Study Design
This is a single-center prospective study.Patient Sample
Patients with adult spinal deformity (ASD) comprise the study sample.Outcome Measures
Oswestry Disability Index (ODI), Short Form-36 (SF-36 Physical Component Score [PCS] and Mental Component Score [MCS]), Scoliosis Research Society-22r (SRS-22r), and PGI.Methods
Oswestry Disability Index, SF-36, SRS-22r, and PGI were administered preoperatively and postoperatively at 6 weeks, 3 months, 6 months, and 1 and 2 years. PGI correlations with ODI, SF-36, SRS total score, free-text frequency analysis of PGI exact response with text in ODI and SRS-22r questionnaires, and the responsiveness (effect size [ES]) of the HRQOL metrics were analyzed. No funding was used for this study and there are no conflicts of interest.Results
A total of 59 patients with 209 clinical encounters produced 370 PGI written response topics that included affect or emotions, relationships, activities of daily life, personal care, work, and hobbies. Mean preoperative PGI score was 18.6±13.5 (0–71.7 out of 100 [best]), and mean scores significantly improved at every postoperative time point (p<.05). Preoperative PGI scores significantly correlated with preoperative ODI (r=?0.28, p=.03), MCS (r=0.48, p<.01), and SRS total (r=0.57, p<.01). Postoperative PGI scores correlated with all HRQOL measures (p<.0001): ODI (r=?0.65), PCS (r=0.50), MCS (r=0.55), and SRS total (r=0.63). PGI responses exactly matched ODI and SRS-22r text at 47.8% and 35.4%, respectively, and at 63.2% and 58.9%, respectively, for categories. Patient Generated Index ES at a minimum of 1-year follow-up was ?2.39, indicating substantial responsiveness (|ES|>0.8). Effect sizes for ODI, SRS-22r total, SF-36 PCS, and SF-36 MCS were 2.16, ?2.06, ?2.05, and ?0.80, respectively.Conclusions
The PGI is easy to administer and offers additional information about the patients' perspective not captured in standard HRQOL metrics. Patient Generated Index scores correlated with all of the standard HRQOL scores and were more responsive than ODI, SF-36, and SRS-22r, suggesting that the PGI may be a step closer to one HRQOL measure that better encompasses concerns and goals of the individual patients. 相似文献4.
K.W.J. Klop R. Timman J.J. Busschbach L.F.C. Dols I.M. Dooper W. Weimar J.N.M. Ijzermans N.F.M. Kok 《Transplantation proceedings》2018,50(1):42-47
Background
Live-kidney donation has a low mortality rate. Evidence suggests that live-kidney donors experience a quality of life (QoL) comparable to or even superior to that of the general population. There is limited information on factors associated with a decrease in QoL in particular for baseline factors, which would improve information to the donor, donor selection, and convalescence.Methods
QoL data on 501 live donors included in three prospective studies between 2001 and 2010 were used. The 36-item short form health survey (SF-36) was used to measure QoL up to 1 year after the procedure. Longitudinal effects on both the mental (MCS) and physical component scales (PCS) were analyzed with multilevel linear regression analyses. Baseline variables were age, gender, body mass index (BMI), pain, operation type, and comorbidity. Other covariates were loss of the graft, glomerular filtration rate, and recipient complications.Results
After 1 year we observed a small decrease in PCS (effect size = ?0.24), whereas the MCS increased (effect size = 0.32). Both PCS and MCS were still well above the norm of the general Dutch population. Factors associated with a change in PCS were BMI (Cohen's d = ?0.17 for 5 BMI points) and age (d = ?0.13 for each 10 years older).Conclusions
Overall, QoL after live-donor nephrectomy is excellent. A lowered PCS is related to age and body weight. Expectations towards a decreased postoperative QoL at 1 year are unjustified. However, one should keep in mind that older and obese donors may develop a reduced physical QoL after live-kidney donation. 相似文献5.
Hideyuki Arima Leah Y. Carreon Steven D. Glassman Yu Yamato Tomohiko Hasegawa Daisuke Togawa Sho Kobayashi Go Yoshida Tatsuya Yasuda Tomohiro Banno Shin Oe Yuki Mihara Yukihiro Matsuyama 《Journal of orthopaedic science》2018,23(1):20-25
Background
The Scoliosis Research Society-22r (SRS-22r) has been shown to be reliable, valid and responsive to change in patients with adult spinal deformity (ASD) undergoing surgery. The minimum clinically important difference (MCID) quantifies a threshold value of improvement that is clinically relevant to the patient. Health-related quality of life scores depend on age. The purpose of this study was to assess MCID threshold values stratified by age for SRS-22r domains in patients with ASD undergoing surgical correction.Methods
We identified a consecutive series of 184 Japanese ASD patients who completed the SRS-22r and Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) preoperatively and 1 year postoperatively. Effectiveness as measured on the JOABPEQ was used as the anchor to determine MCID for the Function, Pain, and Mental health domains using receiver-operating-characteristic (ROC) curve analysis. We performed MCID analysis stratified by age (<70 or ≥70).Results
Mean preoperative SRS-22r Function score was 2.69 improving to 3.23 at postoperatively (p < 0.001). Mean preoperative SRS-22r Pain score was 3.04 improving to 3.78 at postoperatively (p < 0.001). Mean preoperative SRS-22r Mental health score was 2.72 improving to 3.25 at postoperatively (p < 0.001). There was a statistically difference in change in domain score between “not effective” and “effective” (p < 0.001). The ROC curve analysis methods yielded MCID values of 0.58 for Function, 0.55 for Pain, and 0.70 for Mental health domains. There was difference of MCID value for Function and Mental health domain between aged <70 and ≥70; 0.78 and 0.55 for Function; 0.70 and 0.48 for Mental health.Conclusion
Results of this study showed that MCID threshold values for SRS-22 Function and Mental health domains in older than 70 was lower than in younger than 70, potentially implying that older patients have lower expectation. 相似文献6.
Nicolas J. Mouawad Stefan W. Leichtle Christodoulos Kaoutzanis Kathleen Welch Suzanne Winter Richard Lampman Matt McCord Kimberly A. Hoskins Robert K. Cleary 《American journal of surgery》2018,215(4):570-576
Objective
To compare continuous infusion preperitoneal wound catheters (CPA) versus continuous epidural analgesia (CEA) after elective colorectal surgery.Methods
An open-label equivalence trial randomizing patients to CPA or CEA. Primary outcomes were postoperative pain as determined by numeric pain scores and supplemental narcotic analgesia requirements. Secondary outcomes included incidence of complications and patient health status measured with the SF-36 Health Survey (Acute Form).Results
98 patients were randomized [CPA (N = 50, 51.0%); CEA (N = 48, 49.0%)]. 90 patients were included [ CPA 46 (51.1%); CEA 44 (48.9%)]. Pain scores were significantly higher in the CPA group in the PACU (p = 0.04) and on the day of surgery (p < 0.01) as well as supplemental narcotic requirements on POD 0 (p = 0.02). No significant differences were noted in postoperative complications between groups, aggregate SF-36 scores and SF-36 subscale scores.Conclusions
Continuous epidural analgesia provided superior pain control following colorectal surgery in the PACU and on the day of surgery. The secondary endpoints of return of bowel function, length of stay, and adjusted SF-36 were not affected by choice of peri-operative pain control. 相似文献7.
Bestami Yalvaç Nilgün Mesci Duygu Geler Külcü Ozan Volkan Yurdakul 《Acta orthopaedica et traumatologica turcica》2018,52(5):357-362
Objective
The aim of this study was to compare the efficacy of extracorporeal shock wave therapy (ESWT) and therapeutic ultrasound (US) in the treatment of lateral epicondylosis (LE).Methods
Our study enrolled 50 patients with LE. Patients were randomized into two groups. Group 1 underwent therapeutic US (n = 24; 5 males and 15 females; mean age: 43.75 ± 4.52) Group 2 underwent ESWT (n = 20; 8 males and 16 females; mean age: 46.04 ± 9.24). Patients were evaluated at baseline, after treatment,and 1 month following treatment. The outcome measures were the visual analog scale (VAS), algometer, grip dynamometer, quick-disability of the arm,shoulder,and hand (QDASH), patient-rated tennis elbow evaluation (PRTEE), and Short Form-36 (SF-36) health survey questionnairre.Results
Both groups showed significant improvements in terms of VAS (all p values < 0.0001), dynamometer (p = 0.001 vs p = 0.015), algometer (all p values < 0.0001), PRTEE (all p values < 0.0001), QDASH (all p values < 0.0001), and SF-36 scores (p = 0.001 vs p = 0.005) within time. There was no significant difference between the two groups, except algometer scores in favor of ESWT (p = 0.029).Conclusion
ESWT and therapeutic US are equally effective in treating LE. ESWT is an alternative therapeutic intervention and as effective as US.Level of evidence
Level III, Therapeutic study. 相似文献8.
Efthymios Iliopoulos Natasha Morrissey Seok Cho Arshad Khaleel 《Journal of orthopaedic science》2017,22(4):783-786
Aim
The use of circular frame is widely accepted. This is an outcome review on use of circular Ilizarov frame in elderly patients.Materials & methods
Data from all patients treated with an Ilizarov circular frame between January 2002 and December 2014, who were 65 years of age or over at surgery was collected. Seventy Ilizarov circular frames were applied during this period in our unit at a mean age of 71.2 years. Clinical, radiological and quality of life questionnaire (SF-12) data were gathered. Mortality, complication and revision data were also collected.Results
Indications of application of Ilizarov frame were fractures (53%), non-unions (19%), deformity correction (7%) and ankle fusions (21%). Mean period of time in the frame was 184.4 ± 84.2 days. Mortality and complication rates were low (5–7%) at a mean follow-up 4.2 years. There was no case of septic arthritis or newly induced deep infection. Physical and Mental components of SF-12 questionnaire returned to normal for that age group. There was no difference between the subgroups (tibia plateau fractures, pilon fractures, ankle fusions, non-unions, deformity correction and miscellaneous trauma) concerning the physical and mental subjective (PCS and MCS SF-12 component) outcomes (p > 0.05).Conclusions
Ilizarov circular frame as a definitive treatment of many kinds of trauma and orthopaedic conditions can be safely and reliably used in the elderly with good quality of life results. 相似文献9.
Matthew F. Gornet Anne G. Copay Katrine M. Sorensen Francine W. Schranck 《The spine journal》2018,18(7):1292-1297
Background Context
Health-related quality-of-life outcomes have been collected with the Medical Outcomes Study (MOS) Short Form 36 (SF-36) survey. Boston University School of Public Health has developed algorithms for the conversion of SF-36 to Veterans RAND 12-Item Health Survey (VR-12) Physical Component Summary (PCS) and Mental Component Summary (MCS) scores.Purpose
The purpose of the present study is to investigate the conversion of the SF-36 to VR-12 PCS and MCS scores.Study Design
Preoperative and postoperative SF-36 were collected from patients who underwent lumbar or cervical surgery from a single surgeon between August 1998 and January 2013.Methods
Short Form 36 PCS and MCS scores were calculated following their original instructions. The SF-36 answers were then converted to VR-12 PCS and MCS scores following the algorithm provided by the Boston University School of Public Health. The mean score, preoperative to postoperative change, and proportions of patients who reach the minimum detectable change were compared between SF-36 and VR-12.Results
A total of 1,968 patients (1,559 lumbar and 409 cervical) had completed preoperative and postoperative SF-36. The values of the SF-36 and VR-12 mean scores were extremely similar, with score differences ranging from 0.77 to 1.82. The preoperative to postoperative improvement was highly significant (p<.001) for both SF-36 and VR-12 scores. The mean change scores were similar, with a difference of up to 0.93 for PCS and up to 0.37 for MCS. Minimum detectable change (MDC) values were almost identical for SF-36 and VR-12, with a difference of 0.12 for PCS and up to 0.41 for MCS. The proportions of patients whose change in score reached MDC were also nearly identical for SF-36 and VR-12. About 90% of the patients above SF-36 MDC were also above VR-12 MDC.Conclusions
The converted VR-12 scores, similar to the SF-36 scores, detect a significant postoperative improvement in PCS and MCS scores. The calculated MDC values and the proportions of patients whose score improvement reach MDC are similar for both SF-36 and VR-12. 相似文献10.
Peter G. Passias Cyrus M. Jalai Breton G. Line Gregory W. Poorman Justin K. Scheer Justin S. Smith Christopher I. Shaffrey Douglas C. Burton Kai-Ming G. Fu Eric O. Klineberg Robert A. Hart Frank Schwab Virginie Lafage Shay Bess 《The spine journal》2018,18(2):234-244
Background Context
Non-operative management is a common initial treatment for patients with adult spinal deformity (ASD) despite reported superiority of surgery with regard to outcomes. Ineffective medical care is a large source of resource drain on the health system. Characterization of patients with ASD likely to elect for operative treatment from non-operative management may allow for more efficient patient counseling and cost savings.Purpose
This study aimed to identify deformity and disability characteristics of patients with ASD who ultimately convert to operative treatment compared with those who remain non-operative and those who initially choose surgery.Study Design/Setting
A retrospective review was carried out.Patient Sample
A total of 510 patients with ASD (189 non-operative, 321 operative) with minimum 2-year follow-up comprised the patient sample.Outcome Measures
Oswestry Disability Index (ODI), Short-Form 36 Health Assessment (SF-36), Scoliosis Research Society questionnaire (SRS-22r), and spinopelvic radiographic alignment were the outcome measures.Methods
Demographic, radiographic, and patient-reported outcome measures (PROMs) from a cohort of patients with ASD prospectively enrolled into a multicenter database were evaluated. Patients were divided into three treatment cohorts: Non-operative (NON=initial non-operative treatment and remained non-operative), Operative (OP=initial operative treatment), and Crossover (CROSS=initial non-operative treatment with subsequent conversion to operative treatment). NON and OP groups were propensity score-matched (PSM) to CROSS for baseline demographics (age, body mass index, Charlson Comorbidity Index). Time to crossover was divided into early (<1?year) and late (>1?year). Outcome measures were compared across and within treatment groups at four time points (baseline, 6 weeks, 1 year, and 2 years).Results
Following PSM, 118 patients were included (NON=39, OP=38, CROSS=41). Crossover rate was 21.7% (41/189). Mean time to crossover was 394 days. All groups had similar baseline sagittal alignment, but CROSS had larger pelvic incidence and lumbar lordosis (PI-LL) mismatch than NON (11.9° vs. 3.1°, p=.032). CROSS and OP had similar baseline PROM scores; however, CROSS had worse baseline ODI, PCS, SRS-22r (p<.05). At time of crossover, CROSS had worse ODI (35.7 vs. 27.8) and SRS Satisfaction (2.6 vs. 3.3) compared with NON (p<.05). Alignment remained similar for CROSS from baseline to conversion; however, PROMs (ODI, PCS, SRS Activity/Pain/Total) worsened (p<.05). Early and late crossover evaluation demonstrated CROSS-early (n=25) had worsening ODI, SRS Activity/Pain at time of crossover (p<.05). From time of crossover to 2-year follow-up, CROSS-early had less SRS Appearance/Mental improvement compared with OP. Both CROSS-early/late had worse baseline, but greater improvements, in ODI, PCS, SRS Pain/Total compared with NON (p<.05). Baseline alignment and disability parameters increased crossover odds—Non with Schwab T/L/D curves and ODI≥40 (odds ratio [OR]: 3.05, p=.031), and Non with high PI-LL modifier grades (“+”/‘++’) and ODI≥40 (OR: 5.57, p=.007) were at increased crossover risk.Conclusions
High baseline and increasing disability over time drives conversion from non-operative to operative ASD care. CROSS patients had similar spinal deformity but worse PROMs than NON. CROSS achieved similar 2-year outcome scores as OP. Profiling at first visit for patients at risk of crossover may optimize physician counseling and cost savings. 相似文献11.
Selim Ayhan Bilal Aykac Selcen Yuksel Umit Ozgur Guler Ferran Pellise Ahmet Alanay Francisco Javier Sanchez Perez-Grueso Emre Acaroglu ESSG European Spine Study Group 《European spine journal》2016,25(8):2471-2479
Purpose
Spinal surgery for adult spinal deformity (ASD) may require the use of osteotomies, which may have high complication rates (up to 80 %). These may be expected to affect health-related quality of life (HRQOL) in the early postoperative phase but little is known about the clinical course of these patients in the first year following surgery. The aim of the study is to evaluate the radiological results and HRQOL in patients undergoing a spinal osteotomy for ASD within the first year following surgery with special reference to the effect of complications.Methods
From a prospective multicenter ASD database, patients who had undergone a Smith-Petersen osteotomy (SPO), pedicle substraction osteotomy (PSO), vertebral column resection (VCR) or any combination of these were reviewed for radiological sagittal alignment parameters [sagittal vertical axis (SVA), global tilt, lumbar lordosis, T2-sagittal tilt (ST)] as well as HRQOL [Oswestry Disability Index (ODI), short form-36 items (SF-36) Physical Component Score (PCS), SF-36 mental CS (MCS), Scoliosis Research Society (SRS)-22 questionnaire (SRS-22) subtotal] preoperatively and at the 6th- and 12th-month follow-ups with special reference to complications classified as major (life threatening or requiring additional surgery) and minor and their effects on HRQOL.Results
121 patients (85 F, 36 M) with a total of 71 SPOs, 45 PSOs and 13 VCRs were evaluated. Osteotomy resulted in correction of the major coronal Cobb angle from 43.0 ± 3.7° to 24.8 ± 2.8° (p < 0.001) and the SVA from 69.0 ± 10.3 to 52.4 ± 6.6 mm (p = 0.001). Other radiological parameters showed no significant changes. Remarkable improvements in HRQOL scores with a strong age effect (p ≤ 0.01), for all instruments except SF-36 MCS, were found. Most of these HRQOL improvements have been achieved within the first 6 months. A total of 114 complications (59 major, 55 minor) that had a lesser effect on the age-adjusted HRQOL scores (p < 0.05) (except for the SF-36 PCS) and 1 death were observed.Conclusions
Osteotomies were moderately effective in radiological improvement but resulted in a significant increase in HRQOL. They were associated with a high rate of complications but these had no/minimal effect on the clinical outcome. Contrary to the general perception, the greatest improvements in HRQOL were seen to take place during the first 6 months after surgery, even in the presence of complications.12.
Chema Strik Martijn W.J. Stommel Jeroen C. Hol Harry van Goor Richard P.G. ten Broek 《American journal of surgery》2018,215(1):104-112
Background
Adhesiolysis during abdominal surgery can cause iatrogenic organ injury, increased operative time and a more complicated convalescence. We assessed the impact of adhesiolysis and adhesiolysis-related complications on quality of life and functional status following elective abdominal surgery.Methods
Prospective cohort study, comparing patients requiring and not requiring adhesiolysis during an elective laparotomy or laparoscopy using the SF-36 and DASI questionnaire scores.Results
518 patients were included. Pre- and postoperative quality of life did not significantly differ between both groups. Patients with adhesiolysis had a significantly lower pre- and postoperative functional status (p < 0.01). Higher age, concomitant pulmonary disease, postoperative complications, readmissions and chronic abdominal pain 6 months after surgery were all associated with a significant and independent decline in quality of life and functional status six months after surgery.Conclusion
Adhesiolysis in itself does not affect functional status and quality of life six months after surgery. Postoperative complications, readmissions and chronic abdominal pain are associated with a lower health status. 相似文献13.
Yasuhiko Takegami Taisuke Seki Yoshitoshi Higuchi Daigo Komatsu Yoshihiro Nishida Naoki Ishiguro 《Journal of orthopaedic science》2017,22(6):1096-1101
Introduction
This study clarified individual associations of joint space narrowing (JSN) and radiographic features (RF) of hip osteoarthritis (HOA), i.e., cyst and osteophyte formation and subchondral sclerosis, with quality of life (QOL) in Japanese HOA patients.Methods
This cross-sectional study comprised 117 Japanese HOA patients (98 women, 17 men; mean age, 61.2 years). We recorded locations and the size of each RF and measured JSN on the acetabular side (Ace) or femoral head (FH). We evaluated pain with the Visual Analog Scale (VAS) and assessed QOL with the physical component summary (PCS) and mental component summary (MCS) of the Medical Outcomes Study Short Form-36. We compared QOL with/without the RF on the Ace, FH or both and analyzed relationships between each RF and VAS, PCS and MCS with linear regression analysis. We assessed independent associations of each RF with PCS and MCS with multiple regression analysis using various independent variables.Results
VAS values with the cyst on the Ace only were significantly lower than those with the cyst at both locations. PCS values with the cyst on the Ace only were significantly higher than those for both locations. Independent associations existed for maximum cyst length on the Ace and FH with VAS and for JSN with PCS, but none existed for MCS.Conclusions
Our study suggested that the location and the size of the cyst formation were associated with both VAS and QOL in Japanese HOA patients. The JSN was independently associated with the PCS. 相似文献14.
Sevtap Gunay Ucurum Derya Ozer Kaya Yasemin Kayali Ayhan Askin Mustafa Agah Tekindal 《Acta orthopaedica et traumatologica turcica》2018,52(4):249-255
Objective
The aim of this study was to assess and compare the effects of different electrotherapy methods and exercise therapy on pain, function and quality of life in shoulder impingement syndrome.Methods
Eighty-three patients (66 females, 17 males; mean age: 48.2 ± 7.33 years) with shoulder impingement syndrome were selected and 79 of them were randomly allocated into four groups. Group 1 (n = 19, mean age: 47.89 ± 7.12 years) was given hot pack and exercises, Group 2 (n = 20, mean age: 47.70 ± 6.51 years) was given hot packs, exercises and interferential current, Group 3 (n = 20, mean age: 48.50 ± 8.34 years) was given hot packs, exercises and TENS and Group 4 (n = 20, mean age: 48.55 ± 7.89 years) was given hot packs, exercises and ultrasound three times a week for four weeks. Assessments were made before treatment, right after it and three months after that using the visual analog scale (VAS), Short Form-36 (SF-36) and the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measures.Results
At the fourth week and third month assessments, all groups showed significant improvements in terms of pain, DASH and SF-36 physical component scores (p < 0.05). In intragroup comparisons, a significant difference between pre- and post-treatment results was found only in SF-36 mental component scores of Group 2. No significant difference was observed between the groups in any stage of the study period (p > 0.05).Conclusion
Application of ultrasound, interferential current and TENS in addition to exercise therapy in shoulder impingement syndrome treatment had similar improvements in terms of pain, function and physical component of quality of life. However, interferential current treatment showed significantly better outcomes for the mental component of quality of life.Level of evidence
Level I, Therapeutic study. 相似文献15.
Yusuke Osawa Yukiharu Hasegawa Taisuke Seki Yasuhiko Takegami Takafumi Amano Naoki Ishiguro 《Journal of orthopaedic science》2018,23(2):346-349
Background
There has been constant discussion about whether the clinical outcome of THA after periacetabular osteotomy (PAO) is equivalent to that after primary total hip arthroplasty (THA). However, there have been few reports about patient-reported outcomes (PRO) for those who undergo THA after PAO. We compared the pre- and postoperative PRO of patients who underwent THA after PAO and those who underwent primary THA alone.Methods
We performed a case–control study. Twenty-seven patients (29 hips) underwent THA after PAO (osteotomy group); their mean age at surgery was 57.2 years, and they underwent postoperative follow-up for a mean period of 3.0 years. For the control group, after matching age, sex, and Crowe classification, we included 54 patients (58 joints) who underwent primary THA for hip dysplasia. Assessment performed preoperatively and at the last follow-up included the Harris hip score, the Short Form 36 (SF-36) for the Physical Component Summary (PCS), Mental Component Summary (MCS), and Role/Social Component Summary (RCS) domains, Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ) for pain, movement, and mental health, and the visual analog scale (VAS) score of hip pain and satisfaction.Results
The two groups demonstrated no significant difference in the preoperative Harris hip score, each domain of the SF-36, JHEQ, and the VAS score of hip pain and satisfaction. The osteotomy group demonstrated significantly poor Harris hip scores for gait and activity, and JHEQ for movement at the last follow-up. There was no significant difference in each domain of the SF-36 and the VAS score of hip pain and satisfaction at the last follow-up.Conclusion
Previous PAO affects the quality of physical function in patients who undergo subsequent THA. 相似文献16.
Vernissia Tam Waseem Lutfi Stephanie Novak Ahmad Hamad Kenneth K. Lee Amer H. Zureikat Herbert J. Zeh Melissa E. Hogg 《American journal of surgery》2018,215(2):282-287
Background
Adoption of robotics in general surgery has expanded but there is no mandatory national standardized curriculum for general surgery residents (GSR).Methods
A survey was administered to all GSRs in 2014 addressing future practice and robotic experience. A non-mandatory robotic curriculum was available for residents to train. Compliance was assessed. In 2016, the same survey was re-administered. Barriers to completing the curriculum were identified.Results
Interest in improving robotic skills remained high (2014 = 97.8% vs 2016 = 95.9%, p = 0.608), and the majority planned to incorporate robotics into future practice (77.8% vs 69.4%; p = 0.358). Only 11 residents (18%) voluntarily completed the curriculum while 36 (60%) started but did not complete. A trend toward increased procedure participation was seen (60.0%–77.6%, p = 0.066). The perceived barriers to completion of the curriculum were length of time required (80%) and lack of access to a simulator (60%).Conclusions
A structured robotic training curriculum that is non-mandatory is insufficient in helping residents gain fundamental robotic skills. 相似文献17.
The correlation between fundamental characteristics and first-time performance in laparoscopic tasks
Cuan M. Harrington Richard Bresler Donncha Ryan Patrick Dicker Oscar Traynor Dara O. Kavanagh 《American journal of surgery》2018,215(4):618-624
Background
The ability of characteristics to predict first time performance in laparoscopic tasks is not well described. Videogame experience predicts positive performance in laparoscopic experiences but its mechanism and confounding-association with aptitude remains to be elucidated. This study sought to evaluate for innate predictors of laparoscopic performance in surgically naive individuals with minimal videogame exposure.Methods
Participants with no prior laparoscopic exposure and minimal videogaming experience were recruited consecutively from preclinical years at a medical university. Participants completed four visuospatial, one psychomotor aptitude test and an electronic survey, followed by four laparoscopic tasks on a validated Virtual Reality simulator (LAP Mentor?).Results
Twenty eligible individuals participated with a mean age of 20.8 (±3.8) years. Significant intra-aptitude performance correlations were present amongst 75% of the visuospatial tests. These visuospatial aptitudes correlated significantly with multiple laparoscopic task metrics: number of movements of a dominant instrument (rs ≥ ?0.46), accuracy rate of clip placement (rs ≥ 0.50) and time taken (rs ≥ ?0.47) (p < 0.05). Musical Instrument experience predicted higher average speed of instruments (rs ≥ 0.47) (p < 0.05). Participant's revised competitive index level predicted lower proficiency in laparoscopic metrics including: pathlength, economy and number of movements of dominant instrument (rs ≥ 0.46) (p < 0.05).Conclusion
Multiple visuospatial aptitudes and innate competitive level influenced baseline laparoscopic performances across several tasks in surgically naïve individuals. 相似文献18.
Hisateru Niki Naoki Haraguchi Takafumi Aoki Hiroko Ikezawa Kazuo Ouchi Ryuzo Okuda Masataka Kakihana Hiroaki Shima Yasunori Suda Masato Takao Yasuhito Tanaka Kota Watanabe Shinobu Tatsunami 《Journal of orthopaedic science》2017,22(4):737-742
Background
In this study, we investigated the responsiveness of the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) for patient's assessment before and after hallux valgus surgery.Methods
Patient-reported answers on the SAFE-Q and Short Form-36 (SF-36) before and at a mean of 3–4 and 9–12 months after hallux valgus surgery were analyzed. Data of 100 patients (92 women, eight men) from 36 institutions throughout Japan were used for analysis.Results
In all subscales of the SAFE-Q, the trend of increased scores after surgery was statistically significant (P < 0.001). Among the patients with available scores both before and at 9–12 months after surgery (n = 66), the largest effect sizes (ESs) were observed for shoe-related (1.60), pain and pain-related (1.05), and general health and well-being (0.84) scales. In the SF-36 (n = 64), the largest ES was observed for the bodily pain scale (0.86). Less notable changes were observed for the remaining SF-36 domains.Conclusion
The SAFE-Q is the first patient-reported outcome measure which includes a quality of life assessment of shoes. In our cohort, the most remarkable responsiveness was observed for the shoe-related subscale. Based on its responsiveness, the SAFE-Q appears to be sufficient for evaluation of foot-related quality of life before and after surgery. 相似文献19.
Prudence Wing Hang Cheung Carlos King Ho Wong Jason Pui Yin Cheung 《Journal of orthopaedic science》2018,23(5):750-757
Background
Low back pain is a common health problem encountered by various populations among different countries. This prospective study aimed to translate and cross-culturally adapt the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) into Traditional Chinese and to assess its validity, reliability and sensitivity in Chinese patients experiencing low back pain.Methods
Double forward and single back translation of the JOABPEQ was performed with cross-cultural adaptation. By convenience sampling, the final version of the translated JOABPEQ was administered to Chinese patients attending a specialty outpatient clinic with a history of back pain, followed by the traditional Chinese versions of Oswestry Disability Index (ODI) and Short Form-12 version 2 (SF-12v2). Construct validity of the domains were assessed using Spearman's correlation test. Internal consistency was assessed by Cronbach's alpha (α). Sensitivity of the adapted JOABPEQ was determined by known group comparisons.Results
A total of 100 patients were recruited. The translated JOABPEQ demonstrated excellent overall internal consistency (α: 0.912); and good internal consistency for the domains of Lumbar Function, Walking Ability, Social Life Function and Mental Health (α: 0.811, 0.808, 0.788, and 0.827 respectively). Scores of all domains of the translated JOABPEQ had significant correlations (p < 0.01) with ODI at all domains, as well as with almost all domains of SF-12v2 (p < 0.01–0.05). The translated JOABPEQ was sensitive in detecting differences in patients with/without a history of previous spine surgery, and also between patients with acute/acute on chronic versus chronic pain in specific domains.Conclusions
The Traditional Chinese version of JOABPEQ has satisfactory psychometric properties in general, including adequate clinical and construct validity, and internal consistency in assessing Southern-Chinese patients with low back pain. It is demonstrated as a sensitive outcome measure. The translated JOABPEQ is verified for its use in the local clinical setting for patient assessment and future research. 相似文献20.
Tsutomu Akazawa Kota Watanabe Morio Matsumoto Taichi Tsuji Noriaki Kawakami Toshiaki Kotani Tsuyoshi Sakuma Takuya Yamamoto Satoru Demura Sumihisa Orita Kazuki Fujimoto Yasuhiro Shiga Hisateru Niki 《Journal of orthopaedic science》2018,23(6):884-888