Factors Associated With a Discretionary Upper-Extremity Surgery

Tom J. Crijns, David N. Bernstein, David Ring, Ron Gonzalez, Danielle Wilbur, Warren C. Hammert

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)155.e1-155.e7
JournalJournal of Hand Surgery
Volume44
Issue number2
DOIs
StatePublished - Feb 2019

Fingerprint

Upper Extremity
Information Systems
Pain
Social Determinants of Health
Carpal Tunnel Syndrome
Trigger Finger Disorder
Ganglion Cysts
Depression
Psychology
Office Visits
Tendinopathy
Arthritis
Therapeutics
Logistic Models
Patient Reported Outcome Measures

Keywords

  • Coping strategies
  • depression
  • hand surgery
  • physical limitations

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Crijns, T. J., Bernstein, D. N., Ring, D., Gonzalez, R., Wilbur, D., & Hammert, W. C. (2019). Factors Associated With a Discretionary Upper-Extremity Surgery. Journal of Hand Surgery, 44(2), 155.e1-155.e7. https://doi.org/10.1016/j.jhsa.2018.04.028

Factors Associated With a Discretionary Upper-Extremity Surgery. / Crijns, Tom J.; Bernstein, David N.; Ring, David; Gonzalez, Ron; Wilbur, Danielle; Hammert, Warren C.

In: Journal of Hand Surgery, Vol. 44, No. 2, 02.2019, p. 155.e1-155.e7.

Research output: Contribution to journalArticle

Crijns, TJ, Bernstein, DN, Ring, D, Gonzalez, R, Wilbur, D & Hammert, WC 2019, 'Factors Associated With a Discretionary Upper-Extremity Surgery', Journal of Hand Surgery, vol. 44, no. 2, pp. 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. Journal of Hand Surgery. 2019 Feb;44(2):155.e1-155.e7. https://doi.org/10.1016/j.jhsa.2018.04.028
Crijns, Tom J. ; Bernstein, David N. ; Ring, David ; Gonzalez, Ron ; Wilbur, Danielle ; Hammert, Warren C. / Factors Associated With a Discretionary Upper-Extremity Surgery. In: Journal of Hand Surgery. 2019 ; Vol. 44, No. 2. pp. 155.e1-155.e7.
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