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Long-Term Association Between Patient-Reported Outcomes and Psychological Factors in Patients With a Distal Radius
Viktor Schmidt1, Cecilia Tervaniemi1, Mats Wadsten1
1Department of Diagnostics and Intervention, Umeå University, Umeå, Sweden.
Purpose:
The outcome after a distal radius fracture (DRF) is often evaluated with radiography, clinical examination, and patient-reported outcome measures. However, research has identified associations between psychological factors and outcomes after a DRF. A knowledge gap exists about psychological factors and their potential implications for long-term outcomes after a DRF. The aim of this study was to examine the long-term association between psychological factors and patient-reported outcomes.
Methods:
This multicenter investigation included patients aged 15-75 years with closed physes presenting with an acute DRF. Patients who completed a long-term follow-up (after 11-13 years) with patient-reported outcome measures were invited to participate in the study, and surveys measuring psychological factors were sent to the patients.
Results:
Two hundred and four patients (70%) completed the follow-up (mean [range] age at injury, 56 [18-75] years; 154 were females [75%]). Multivariable analysis showed that higher age, injury to the dominant hand, and greater pain catastrophizing were associated with an increase in scores on the Disabilities of the Arm, Shoulder, and Hand questionnaire.
Conclusions:
A decade after sustaining a DRF, patients with higher scores on the Pain Catastrophizing Scale reported inferior outcomes as measured by the Disabilities of the Arm, Shoulder, and Hand. The Pain Catastrophizing Scale accounts for 13% of the observed variance in Disabilities of the Arm, Shoulder, and Hand.
Type Of Study/Level Of Evidence:
Therapeutic level IIb.
