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Factors Associated With a Discretionary Upper-Extremity Surgery.

Publication ,  Journal Article
Crijns, TJ; Bernstein, DN; Ring, D; Gonzalez, R; Wilbur, D; Hammert, WC
Published in: J Hand Surg Am
February 2019

PURPOSE: Surgery for nontraumatic upper-extremity problems is largely discretionary and preference-sensitive. Psychological and social determinants of health correlate with greater symptoms and limitations and might be associated with discretionary operative treatment. METHODS: We used routinely collected patient-reported outcome measures from patients with de Quervain tendinopathy, ganglion cyst, trapeziometacarpal arthritis, trigger digit, and carpal tunnel syndrome to study factors associated with discretionary surgery using multiple logistic regression. Patients completed a measure of the magnitude of physical limitations (Patient-Reported Outcomes Measurement Information System [PROMIS] Physical Function Computerized Adaptive Test [CAT]), a measure of the degree to which a person limits activities owing to pain (PROMIS Pain Interference CAT), and a measure of symptoms of depression (PROMIS Depression CAT) at every office visit. RESULTS: Higher PROMIS Pain Interference score, diagnoses of carpal tunnel syndrome, and treatment by teams 3, 4, or 5 were independently associated with discretionary operative treatment. CONCLUSIONS: People with a greater tendency to limit activity owing to pain are more likely to choose discretionary surgery. CLINICAL RELEVANCE: Interventions that help people remain active despite pain by addressing the psychological and social determinants of health might affect the rate of discretionary surgery.

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Published In

J Hand Surg Am

DOI

EISSN

1531-6564

Publication Date

February 2019

Volume

44

Issue

2

Start / End Page

155.e1 / 155.e7

Location

United States

Related Subject Headings

  • Wrist
  • Trigger Finger Disorder
  • Patient Reported Outcome Measures
  • Patient Acceptance of Health Care
  • Pain
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Ganglion Cysts
 

Citation

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Crijns, T. J., Bernstein, D. N., Ring, D., Gonzalez, R., Wilbur, D., & Hammert, W. C. (2019). Factors Associated With a Discretionary Upper-Extremity Surgery. J Hand Surg Am, 44(2), 155.e1-155.e7. https://doi.org/10.1016/j.jhsa.2018.04.028
Crijns, Tom J., David N. Bernstein, David Ring, Ron Gonzalez, Danielle Wilbur, and Warren C. Hammert. “Factors Associated With a Discretionary Upper-Extremity Surgery.J Hand Surg Am 44, no. 2 (February 2019): 155.e1-155.e7. https://doi.org/10.1016/j.jhsa.2018.04.028.
Crijns TJ, Bernstein DN, Ring D, Gonzalez R, Wilbur D, Hammert WC. Factors Associated With a Discretionary Upper-Extremity Surgery. J Hand Surg Am. 2019 Feb;44(2):155.e1-155.e7.
Crijns, Tom J., et al. “Factors Associated With a Discretionary Upper-Extremity Surgery.J Hand Surg Am, vol. 44, no. 2, Feb. 2019, pp. 155.e1-155.e7. Pubmed, doi:10.1016/j.jhsa.2018.04.028.
Crijns TJ, Bernstein DN, Ring D, Gonzalez R, Wilbur D, Hammert WC. Factors Associated With a Discretionary Upper-Extremity Surgery. J Hand Surg Am. 2019 Feb;44(2):155.e1-155.e7.
Journal cover image

Published In

J Hand Surg Am

DOI

EISSN

1531-6564

Publication Date

February 2019

Volume

44

Issue

2

Start / End Page

155.e1 / 155.e7

Location

United States

Related Subject Headings

  • Wrist
  • Trigger Finger Disorder
  • Patient Reported Outcome Measures
  • Patient Acceptance of Health Care
  • Pain
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Ganglion Cysts