Longitudinal Evaluation of Patient-reported Outcomes Measurement Information System (PROMIS) Scores in Children Under...

Area of Science:

• Pediatric Orthopedics
• Rehabilitation Medicine
• Child Health Outcomes

Background:

• Legg-Calvé-Perthes Disease (LCPD) is an idiopathic ischemic hip disorder impacting children.
• Children under 6 with LCPD are understudied, despite being a significant patient group.
• This study focuses on longitudinal outcomes in this young demographic.

Purpose of the Study:

• To evaluate longitudinal Patient-Reported Outcomes Measurement Information System (PROMIS) scores in children diagnosed with LCPD before age 6.
• To understand the evolution of functional and emotional well-being in relation to disease progression.
• To provide data for setting realistic expectations for families.

Main Methods:

• A multicenter prospective cohort study included 181 children (188 hips) diagnosed with LCPD at age 6 or younger.
• PROMIS T-scores (mobility, pain, fatigue, depression, anxiety, anger, peer relationships) were assessed.
• Linear mixed-effects regression models analyzed PROMIS scores against Waldenström stages, adjusting for covariates.

Main Results:

• PROMIS scores were analyzed across Waldenström stages in 181 children (median age 4.6 years).
• At stage I, most domains showed mild impairment, except normal depression and fatigue.
• Pain interference and anger normalized by stage IIa, mobility by stage IIIa, and anxiety by stage IIIb.

Conclusions:

• PROMIS T-scores demonstrated significant improvements across multiple domains as LCPD patients under 6 advanced through Waldenström stages.
• These findings offer valuable insights into the natural history of LCPD in young children.
• The data can assist clinicians in guiding families regarding prognosis and expected recovery trajectories.