Predictors of patient and surgeon satisfaction after orthopaedic trauma

Introduction

Patient satisfaction has only recently gained attention as an outcome measure in orthopaedics, where it has been reported for joint replacement surgery. Little has been published regarding predictors of patient satisfaction in orthopaedic trauma. This study aims to explore the predictors of patient satisfaction, and of surgeon satisfaction, after orthopaedic trauma.

Materials and methods

Adult patients admitted to hospital with fractures after motor vehicle trauma were surveyed on admission, and at six months. Demographic, injury, socio-economic and compensation-related factors were measured. The two outcomes were satisfaction with progress of the injury, and satisfaction with recovery. The treating surgeons were also surveyed at six months to determine surgeon satisfaction with progress, and recovery (using the same questions), and the presence or absence of fracture union and any complications. Multivariate analysis was used to determine significant predictors of satisfaction for both groups, and satisfaction rates were compared between surgeons and patients.

Results

Of 306 patients recruited, 232 (75.8%) returned completed questionnaires, but only 141 (46.1%) surgeons responded. Patients rated their satisfaction with progress and recovery as 74.6% and 44.4%, respectively, whereas surgeon-rated satisfaction with progress and recovery was significantly higher, at 88.0% and 66.7%, respectively (p < 0.0001).Significant predictors of patient dissatisfaction were: blaming others for the injury, being female, and using a lawyer. Patient-rated satisfaction was not significantly associated with objective injury or treatment factors. The only significant predictor of surgeon dissatisfaction was fracture non-union.

Conclusions

Orthopaedic surgeons overestimated the progress of the injury and the level of recovery compared to patients’ own ratings. Surgeons’ ratings were influenced by objective, treatment-related factors, whereas patients’ ratings were not. Measures of outcome commonly used by orthopaedic surgeons, such as fracture union, do not predict patient satisfaction.

Level of evidence

Level II evidence (prognostic, prospective study).