The PROMIS-10 Global Mental Health T-Score: An Independent Predictor of In-Hospital Recovery Following a Total Hip
Regina O Kostyun1, Daniel K Witmer, Peter Lucchio
1From the Hartford Hospital's Bone and Joint Institute, Hartford, CT (Kostyun, Witmer, Lucchio, and Solomito), and the Orthopedic Associates of Hartford, Hartford, CT (Dr. Witmer).
Background:
Currently, few investigations explore the connection between global mental health and recovery following total hip arthroplasty (THA). The increased utilization of patient-reported outcomes tools provides an opportunity to assess a patient's mental health without undue survey burden. The purpose of this study was to explore how mental health is associated with a patient's immediate in-hospital recovery regardless of a formally diagnosed mental illness.
Methods:
This retrospective study consisted of patients undergoing elective primary THA. Patients were grouped by both their PROMIS 10 Global Mental Health T-score (MHT) and whether they had a formally diagnosed mental illness. The resulting four patient groups were compared using multivariate regression analyses to determine differences in in-hospital pain reporting, opioid consumption, and discharge disposition.
Results:
One thousand four hundred and twenty nine patients were included in this study. MHT was an independent predictor of pain reporting at discharge ( P < 0.001) and inpatient opioid consumption ( P = 0.002). Regardless of the presence of mental illness, patients self-reporting poor mental health (MHT<40) reported higher pain levels, consumed more opioids, and were more likely to be discharged to a facility than those with an MHT >50.
Conclusion:
Mental illness was not an independent predictor of immediate postoperative outcomes, but self-reported global mental health assessed using the MHT was. Therefore, surgeons should be aware of their patient's global mental health status before surgery because it is associated with in-hospital recovery following THA.
