What factors are predictors of emotional health in patients with full-thickness rotator cuff tears?

Barlow, Jonathan D.; Bishop, Julie Y.; Dunn, Warren R.; Kuhn, John E.

doi:10.1016/j.jse.2016.04.007

Cited by 24 publications

(24 citation statements)

References 30 publications

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“…Our study showed that compared with a patient with VR-12 MCS of 43.1 (25th percentile), a patient with VR-12 MCS of 60.5 (75th percentile) had a 1.94-point higher PSS pain score, 3.65-point higher PSS function score, and 5.78-point higher total PSS, as well as a 25% higher odds of achieving a certain PSS satisfaction score, after we controlled for all other variables. This is in agreement with several previous studies that have shown baseline mental health status to be closely associated with shoulder pain and disability at baseline, [1][2][3]6,21,35,36 as well as with outcomes after repair 10,23,30,34 in patients with RC tears. Although this finding is consistent, the reason that lower mental health status accompanies poorer total PSS and subscale scores remains unclear.…”

Section: Discussionsupporting

confidence: 93%

Associations of Preoperative Patient Mental Health and Sociodemographic and Clinical Characteristics With Baseline Pain, Function, and Satisfaction in Patients Undergoing Rotator Cuff Repairs

et al. 2019

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Background: Shoulder pain and dysfunction are common indications for rotator cuff repair surgery, yet the factors that are associated with these symptoms are not fully understood. Purpose/Hypothesis: This study aimed to investigate the associations of patient and disease-specific factors with baseline patient-reported outcome measures (PROMs) in patients undergoing rotator cuff repair. We hypothesized that tear size and mental health status, as assessed by the Veterans RAND 12-Item Health Survey mental component score (VR-12 MCS), would be associated with baseline total Penn Shoulder Score (PSS) and its pain, function, and satisfaction subscale scores. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We prospectively identified 12 patient factors and 12 disease-specific factors as possible statistical predictors for baseline PROMs in patients undergoing surgical repair of superior-posterior rotator cuff tears at a single institution over a 3-year period. Multivariable statistical modeling and Akaike information criterion comparisons were used to investigate the unique associations with, and relative importance of, these factors in accounting for variation in baseline PSS and its subscale scores. Results: A total of 1442 patients who had undergone surgery by 23 surgeons met inclusion criteria, with a baseline median total PSS of 38.5 (pain, 12; function, 24.2; satisfaction, 2). Adjusted R2 in multivariable models demonstrated that the 24 general patient and disease-specific factors accounted for 22% to 24% of the variability in total PSS and its pain and function subscale scores. Large/massive tear size was significantly associated with worse PSS total score and function score but not pain or satisfaction scores. Lower VR-12 MCS was significantly associated with worse total PSS and all 3 subscale scores. Among other factors significantly associated with baseline PROMs were sex, race, preoperative opioid use, years of education, employment status, acromion status, and adhesive capsulitis. Lower VR-12 MCS, preoperative opioid use, female sex, and black race were the factors most strongly associated with baseline PROMs. Conclusion: Large/massive tear size, lower VR-12 MCS, and several additional patient and disease-specific factors are associated with baseline PROMs in patients undergoing rotator cuff repair. Further studies are needed to investigate whether these factors will also predict poor postoperative PROMs.

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Section: Discussionsupporting

confidence: 93%

Associations of Preoperative Patient Mental Health and Sociodemographic and Clinical Characteristics With Baseline Pain, Function, and Satisfaction in Patients Undergoing Rotator Cuff Repairs

et al. 2019

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“…Of the 10 studies, five were cross-sectional [2,10,60,80,89] and five were prospective cohort studies [11,31,59,61,88]. Four of the five prospective studies assessed outcomes at least 12 months after surgery [11,31,59,61], whereas one study measured outcome at 6 months after surgery [88].…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

Are Psychosocial Factors Associated With Patient-reported Outcome Measures in Patients With Rotator Cuff Tears? A Systematic Review

Coronado

Seitz

Pelote

et al. 2018

Clin Orthop Relat Res

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“… 42 , 43 , 48 Surgical candidacy may also affect the injured worker’s physical and psychological well-being. 1 , 6 By matching the groups on these confounding variables, we were able to provide an accurate analysis of other differences between the patients with and without APRs.…”

Section: Discussionmentioning

confidence: 99%

Abnormal Pain Response After a Compensable Shoulder Injury

Razmjou

Boljanovic

Elmaraghy

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:The role of psychosocial factors has been established in patients with shoulder abnormalities. However, the prevalence of exaggerated pain behaviors and their association with the characteristics of injured workers have not been well studied.Purpose:To examine the prevalence of abnormal pain responses (APRs) in workers with active workers’ compensation claims for a shoulder injury and to examine the differences between workers with APRs versus workers without APRs.Study Design:Cross-sectional study; Level of evidence, 3.Methods:An analysis of electronic data files of injured workers was completed. An APR was defined as an exaggerated pain response during a clinical examination, including facial grimacing, shaking, withdrawal, nonanatomic dermatome or myotome disturbances, increased tenderness, regional symptoms, and verbal utterances such as groaning, moaning, or gasping. To control for potential confounders, patients with positive APRs (APR group) were matched with injured workers without APRs (control group) seen in the same clinic and matched for sex, age, and surgical candidacy.Results:Data from 1000 workers who had sustained a shoulder injury at work and who were referred for an early assessment by an orthopaedic surgeon and a physical therapist were reviewed. A total of 86 (9%) injured workers (mean age, 47 ± 11 years; 55 [64%] female) demonstrated APRs and were matched with 86 injured workers without APRs. There were no statistically significant between-group differences in the wait time, mechanism of injury, coexisting comorbidity, type of abnormality, or medication consumption. The APR group reported higher levels of disability (P < .0001) and psychological problems (P < .0001), presented with more inconsistency in range of motion (P = .04), and had more limitations at work (P = .02).Conclusion:The presence of an APR after a compensable shoulder injury was associated with higher reports of disability and psychological problems. Patients with positive APRs were more likely to be off work and less likely to perform full duties.

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What factors are predictors of emotional health in patients with full-thickness rotator cuff tears?

Cited by 24 publications

References 30 publications

Associations of Preoperative Patient Mental Health and Sociodemographic and Clinical Characteristics With Baseline Pain, Function, and Satisfaction in Patients Undergoing Rotator Cuff Repairs

Associations of Preoperative Patient Mental Health and Sociodemographic and Clinical Characteristics With Baseline Pain, Function, and Satisfaction in Patients Undergoing Rotator Cuff Repairs

Are Psychosocial Factors Associated With Patient-reported Outcome Measures in Patients With Rotator Cuff Tears? A Systematic Review

Abnormal Pain Response After a Compensable Shoulder Injury

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