A Pilot Study Using a Standardized Method of Measuring Distress Demonstrates Higher Levels in Septic Revisions

Area of Science:

• Orthopaedic Surgery
• Infectious Diseases
• Psychological Medicine

Background:

• Multidisciplinary clinics for prosthetic joint infection (PJI) patients mirror cancer care models.
• The National Comprehensive Cancer Network's distress thermometer (DT) is a validated tool for assessing patient distress.
• This study proposes adapting the DT for PJI patients to quantify their psychological burden.

Purpose of the Study:

• To evaluate the utility of the distress thermometer (DT) in assessing psychological distress in patients with prosthetic joint infections (PJI).
• To compare distress levels in PJI patients with those undergoing aseptic revision surgery.
• To establish the need for distress screening in PJI management.

Main Methods:

• A retrospective pilot study analyzed patients from a combined Orthopaedic Infectious Disease Clinic over two years.
• Patients completed a questionnaire and a modified distress thermometer (DT).
• DT scores from the PJI group were compared to a matched aseptic control group.

Main Results:

• The PJI group (n=122) reported a significantly higher mean DT score (6.18 ± 3.2) compared to the aseptic group (n=40, 3.33 ± 2.06; P < .0001).
• Over 75% of PJI patients scored ≥4 on the DT, indicating a need for support.
• Twenty-one percent of PJI patients reported extreme distress (DT score ≥10), versus none in the aseptic group.

Conclusions:

• Prosthetic joint infection (PJI) patients exhibit substantially higher distress levels than aseptic revision patients.
• Clinical attention and systematic measurement of distress are necessary for PJI patient care.
• Implementing distress screening can enhance comprehensive care, potentially improving compliance, outcomes, and resource allocation for PJI treatment.