Patient coping and expectations predict recovery after major orthopaedic trauma

Area of Science:

• Orthopedic Surgery
• Pain Medicine
• Psychological Medicine

Background:

• Persistent post-surgical pain and disability are common following traumatic fracture repair.
• Patient beliefs and perceptions may significantly influence recovery outcomes.

Purpose of the Study:

• To investigate the association between Somatic PreOccupation and Coping (SPOC) scores and patient recovery after surgical repair of open fractures.
• To determine if SPOC scores can predict persistent pain, pain interference, and quality of life at one year post-surgery.

Main Methods:

• Utilized data from 1560 open fracture patients undergoing surgical repair from the Fluid Lavage of Open Wounds trial.
• Assessed Somatic PreOccupation and Coping (SPOC) using a validated questionnaire at 6 weeks post-surgery.
• Employed multivariable regression models to analyze the association between SPOC scores and recovery outcomes at 1 year.

Main Results:

• High SPOC scores (≥74) were significantly associated with persistent moderate to extreme pain (66.7% of patients) at 1 year (OR: 5.63).
• High SPOC scores also predicted increased pain interference (38% of patients) at 1 year (OR: 6.06).
• SPOC scores explained 10% of the variance in physical and 14% in mental component summary scores of the SF-12 at 1 year.

Conclusions:

• High Somatic PreOccupation and Coping (SPOC) questionnaire scores at 6 weeks post-surgery are predictive of persistent pain and reduced quality of life.
• SPOC scores are valuable in identifying open fracture patients at risk for poor long-term recovery.
• Early psychological assessment may aid in targeted interventions for improved surgical outcomes.