Outcomes at 3 weeks predicted patient dissatisfaction with hand surgery at 1 year
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Use of the QuickDASH score in the early postoperative period to assess function and overall satisfaction with hand surgery can positively impact the recovery trajectory of patients, according to study results.
At the virtual American Society for Surgery of the Hand Annual Meeting, Orrin I. Franko, MD, of East Bay Hand Medical Center in San Leandro, California, presented findings from what the society named as one of the best papers of the meeting.
He said, “Three-week postoperative patient-reported outcomes correlate with 1-year patient satisfaction.”
Franko and William Slikker III, MD, retrospectively studied findings for 4,141 patients who underwent hand surgery and were in included in a cloud-based automated data collection registry. All patients included in the study had 1 year of data collection.
Patients were administered patient-reported outcome scores, which included the QuickDASH as a measure of their satisfaction with their surgery, preoperatively and at 3, 6, 12, 24 and 52 weeks postoperatively.
A 3-week total of -3.9 points change from baseline of the QuickDASH was used as the threshold to distinguish patients who were satisfied and “definitely” or “most likely” would repeat surgery from patients who were dissatisfied and were “unsure” or said they were “probably not” likely or were “definitely not” likely to repeat their surgery.
Researchers extrapolated those early score changes to changes in the QuickDASH at 6, 12, 24 and 52 weeks postoperatively. They found only the dissatisfied group of patients, whose scores indicated they would “definitely not” repeat surgery, had increased QuickDASH scores. The scores in that group were +7 points at 3 weeks and +2.9 points at 6 weeks postoperatively, according to the results.
“These dissatisfied patients at 1 year are the only group to demonstrate an increase in QuickDASH scores during their recovery and did so as early as 3 weeks. Therefore, real-time automated patient-reported outcomes may have the potential to identify these dissatisfied patients very early in their recovery period, as early as 3 weeks, and provide an opportunity to intervene and change their outcome and long-term satisfaction,” Franko said, noting this study is ongoing, as is the database.
“It’s important to recognize the limitations of this early study. These are averaged data for cohorts and may not reflect individual results. This retrospective analysis may not reflect prospective data collection for future studies and additional analyses are required,” Franko said.
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Franko OI, et al. Paper 5. Presented at: American Society for Surgery of the Hand Annual Meeting; Oct. 1-3, 2020 (virtual meeting).
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