Predicting Outcomes After Distal Radius Fracture: A 24-Center International Clinical Trial of Older Adults.

Published

Journal Article

PURPOSE: Current evidence on predictors of outcomes after distal radius fracture is often based on retrospective analyses or may be confounded by fracture type. Using data from the Wrist and Radius Injury Surgical Trial (WRIST), a 24-site randomized study of distal radius fracture treatment, in which all fractures are severe enough to warrant surgery, we set out to perform a secondary data analysis to explore predictors of better or worse hand outcomes. METHODS: The primary outcome measure was the Michigan Hand Outcomes Questionnaire (MHQ) summary score 12 months after treatment. We used a regression tree analysis with recursive partitioning to identify subgroups of participants who experienced similar outcomes (ie, MHQ score) and to determine which baseline or treatment factors they had in common. RESULTS: Factors most predictive of 12-month MHQ score were pain at enrollment, education, age, and number of comorbidities. Specifically, participants who had a high school education or less and also reported severe pain had the lowest MHQ scores. Conversely, participants with less pain and more education and who were age 87 years or younger with one or no comorbid condition had the highest MHQ scores. Treatment type or radiographic measurements assessed on post-reduction films did not affect 12-month outcomes. CONCLUSIONS: These results identified patient characteristics that can be used by surgeons to identify subgroups of patients who may experience similar hand outcomes. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic III.

Full Text

Duke Authors

Cited Authors

  • Chung, KC; Kim, HM; Malay, S; Shauver, MJ; WRIST Group,

Published Date

  • September 2019

Published In

Volume / Issue

  • 44 / 9

Start / End Page

  • 762 - 771

PubMed ID

  • 31345563

Pubmed Central ID

  • 31345563

Electronic International Standard Serial Number (EISSN)

  • 1531-6564

Digital Object Identifier (DOI)

  • 10.1016/j.jhsa.2019.05.016

Language

  • eng

Conference Location

  • United States