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Higher Baseline Resiliency Scores Correlate With Better Patient-Reported Outcomes After Acetabular Fixation
Ryan N McIlwain1, Robin M Litten1, Mary Jane McConnell2
1Department of Orthopaedic Surgery, University of Alabama at Birmingham; Birmingham, AL.
Objectives:
To determine whether patient resiliency is associated with patient-reported outcomes at 6 and 12 months after surgical fixation of acetabular fractures.
Design:
Retrospective cohort study.
Setting:
Single Level I trauma center (2022-2024).
Patient Selection Criteria:
Adults who sustained an acetabulum fracture (AO/OTA 62) treated operatively and completed Brief Resilience Scale (BRS) surveys 2 weeks postoperatively and Patient-Reported Outcomes Measurement Information System (PROMIS) surveys at 6 and/or 12 months postoperatively were included.
Outcome Measures And Comparisons:
Primary outcomes were scores for PROMIS physical function, global physical health, global mental health, pain interference, depression, anxiety, and BRS. PROMIS scores were compared between low- and high-resiliency individuals at 6 and 12 months, as defined by the cohort median BRS score. Multivariable linear regression was used to adjust for relevant clinical covariates.
Results:
A total of 111 patients were included; 81 patients (64.2% male, 60.5% White; mean age 51.1 years) completed 6-month surveys and 56 patients (75.0% male, 66.1% White; mean age 51.8 years) completed 12-month surveys. At 6 months, high resiliency BRS (≥3.7) was independently associated with higher PROMIS physical function (β = 6.73 [2.93-10.54], P < 0.001), global physical health (β = 8.88 [5.47-12.28], P < 0.001), and global mental health (β = 12.40 [8.48-16.32], P < 0.001) with lower pain interference (β = -7.83 [-11.25 to -4.40], P < 0.001), depression (β = -15.33 [-19.69 to -10.97], P < 0.001), and anxiety (β = -11.54 [-16.35 to -6.72], P < 0.001) scores on regression analysis. Similarly, highly resilient (BRS ≥ 3.6) individuals completing 12-month surveys had significantly positive associations across all domains.
Conclusions:
Compared with patients with low resilience, high baseline resilience was associated with significantly better PROMIS outcomes at 6 and 12 months after acetabular fixation.
Level Of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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