Aaron Alokozai|Sara L. Eppler|Laura Lu|Nicole Sheikholeslami|Robin N. Kamal
Can Patients Forecast Their Postoperative Disability and Pain?
Stanford University|Stanford Medicine|Clinical Orthopaedics and Related Research|Stanford University|Stanford Medicine|Clinical Orthopaedics and Related Research|Stanford University|Stanford Medicine|Clinical Orthopaedics and Related Research|Clinical Orthopaedics and Related Research|Stanford University|Stanford Medicine|Stanford University|Stanford Medicine|Clinical Orthopaedics and Related Research
forecasting construct experiences beliefs inform projection future outcomes current efforts predict postoperative patientreported outcome measures riskstratifying models focus studying patient surgeon facility variables without considering mindset patient evidence assessing association patients forecasted postoperative disability realized postoperative disability patientforecasted disability could potentially used tool predict postoperative disability1 patientforecasted disability pain correlate patientrealized disability pain hand surgery 2 factors associated patient ability forecast disability painwe completed prospective longitudinal study assess association forecasted realized postoperative pain disability predictive tool one hundred eighteen patients one handupper extremity surgeon recruited november 2016 february 2018 inclusion criteria study patients undergoing hand upper extremity surgery older 18 years age english fluency literacy enrolled 118 patients 32 patients 27 dropped result incomplete postoperative questionnaires total number patients eligible tracked eightysix patients completed preoperative postoperative questionnaires exclusion criteria included patients unable give informed consent children patients dementia nonenglish speakers surgery patients completed questionnaire asked forecast upper extremity disability dash shortened disabilities arm shoulder hand quickdash pain vas pain 0 10 2 weeks procedure questionnaire also queried following psychologic factors explanatory variables addition demographic socioeconomic variables general self efficacy scale pain catastrophizing scale patient health questionnaire depression scale 2week followup appointment patients completed quickdash pain vas assess realized disability pain scores bivariate analysis used test association forecasted realized disability pain reporting pearson correlation coefficients unpaired ttests performed test association demographic variables example men vs women association forecasted realized disability pain levels oneway analysis variance used variables multiple groups example annual salary ethnicity p values 005 considered statistically significantforecasted postoperative disability moderately correlated realized postoperative disability r 059 p 0001 forecasted pain weakly correlated realized postoperative pain r 028 p 0011 total 47 patients n 40 able predict disability score within mcid realized disability score symptoms depression also correlated increased realized postoperative disability r 037 p 0001 increased realized postoperative pain r 042 p 0001 catastrophic thinking correlated increased realized postoperative pain r 031 p 0004 patients symptoms depression realized greater pain postoperatively forecasted preoperatively r 024 p 0028 association symptoms depression patients ability forecast disability r 02 p 0058 patient age associated patients ability forecast disability r 27 p 0011 catastrophic thinking selfefficacy number prior surgical procedures associated patients ability forecast postoperative disability painpatients undergoing hand surgery moderately forecast postoperative disability surgeons use forecasted disability identify patients may experience greater disability compared benchmarks example forecast experience high quickdash scores surgery inform preoperative discussions interventions focused expectation management resilience mindsetlevel iii prognostic study