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Sleep disturbance, dyspnea, and anxiety following total joint arthroplasty: an observational study.

Publication ,  Journal Article
George, SZ; Bolognesi, MP; Ryan, SP; Horn, ME
Published in: J Orthop Surg Res
August 19, 2022

BACKGROUND: Patient-Reported Outcomes Measurement Information System (PROMIS) domains for sleep disturbance, anxiety, and dyspnea have been under-reported for total joint arthroplasty (TJA). The aims of this study were to report postoperative differences for these domains based on TJA location and chronic pain state. We also investigated whether these domains were associated with physical function and pain interference outcomes. METHODS: This was a retrospective, observational study of patients who underwent hip, knee, or shoulder TJA (primary and revision surgeries) at a single academic tertiary referral center. A subset of these patients completed an email-based survey for chronic pain grade (Chronic Pain Grade Scale-Revised) and sleep disturbance, anxiety, dyspnea, physical function, and pain interference (PROMIS short forms). Pre-operative and operative data were extracted from the electronic health record. Data analysis investigated PROMIS domains for differences in TJA location and chronic pain grade. Hierarchical linear regression determined associations of these domains with physical function and pain interference. RESULTS: A total of 2638 individuals provided informed consent and completed the email survey. In the ANOVA models for sleep disturbance, anxiety, and dyspnea, there was no location by chronic pain grade interaction (p > 0.05) and no difference based on TJA location (p > 0.05). There were differences for chronic pain grade (p < 0.01). The poorest postoperative outcome score for each domain was associated with high impact chronic pain. Furthermore, sleep disturbance and dyspnea had the strongest associations with physical function and pain interference (p < 0.01). CONCLUSIONS: Sleep disturbance, anxiety, and dyspnea did not vary based on TJA location, but were associated with postoperative chronic pain grade. Sleep disturbance and dyspnea were strongly associated with commonly reported outcomes of physical function and pain interference. These findings provide guidance for those interested in expanding TJA outcome assessment to include sleep disturbance, anxiety, and/or dyspnea.

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Published In

J Orthop Surg Res

DOI

EISSN

1749-799X

Publication Date

August 19, 2022

Volume

17

Issue

1

Start / End Page

396

Location

England

Related Subject Headings

  • Sleep Wake Disorders
  • Sleep
  • Pain, Postoperative
  • Orthopedics
  • Humans
  • Dyspnea
  • Depression
  • Chronic Pain
  • Arthroplasty
  • Anxiety
 

Citation

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George, S. Z., Bolognesi, M. P., Ryan, S. P., & Horn, M. E. (2022). Sleep disturbance, dyspnea, and anxiety following total joint arthroplasty: an observational study. J Orthop Surg Res, 17(1), 396. https://doi.org/10.1186/s13018-022-03288-x
George, Steven Z., Michael P. Bolognesi, Sean P. Ryan, and Maggie E. Horn. “Sleep disturbance, dyspnea, and anxiety following total joint arthroplasty: an observational study.J Orthop Surg Res 17, no. 1 (August 19, 2022): 396. https://doi.org/10.1186/s13018-022-03288-x.
George SZ, Bolognesi MP, Ryan SP, Horn ME. Sleep disturbance, dyspnea, and anxiety following total joint arthroplasty: an observational study. J Orthop Surg Res. 2022 Aug 19;17(1):396.
George, Steven Z., et al. “Sleep disturbance, dyspnea, and anxiety following total joint arthroplasty: an observational study.J Orthop Surg Res, vol. 17, no. 1, Aug. 2022, p. 396. Pubmed, doi:10.1186/s13018-022-03288-x.
George SZ, Bolognesi MP, Ryan SP, Horn ME. Sleep disturbance, dyspnea, and anxiety following total joint arthroplasty: an observational study. J Orthop Surg Res. 2022 Aug 19;17(1):396.
Journal cover image

Published In

J Orthop Surg Res

DOI

EISSN

1749-799X

Publication Date

August 19, 2022

Volume

17

Issue

1

Start / End Page

396

Location

England

Related Subject Headings

  • Sleep Wake Disorders
  • Sleep
  • Pain, Postoperative
  • Orthopedics
  • Humans
  • Dyspnea
  • Depression
  • Chronic Pain
  • Arthroplasty
  • Anxiety