HIGH LEVELS OF DYSFUNCTION AND IMPAIRED QUALITY OF LIFE IN PATIENTS PRESENTING WITH A NONUNION OR BONE DEFECT SCHEDULED TO UNDERGO A BONE GRAFTING PROCEDURE
Notice bibliographique
Résumé
Non-unions and bone defects are devastating injuries that can significantly affect patient's quality of life and function. The purpose of this study was to examine the baseline characteristics, level of function and quality of life in patients scheduled to undergo a bone grafting procedure for a non-union or bone defect. This study is an analysis of baseline data from a multi-centre, randomized controlled trial. Patients aged 18 to 65 with a non-union or bone defect of a long bone, requiring a bone grafting procedure, were enrolled. At baseline patients completed the Short Musculoskeletal Function Assessment (SMFA, where higher scores on the dysfunction index indicate increased dysfunction) and the 12-item Short Form Survey (SF-12). The Physical Component Summary (PCS) and Mental Component Summary (MCS) were calculated from the SF-12. Multiple linear regression analyses were performed to determine variables associated with SMFA function scores and SF-12 PCS and MCS scores. Variables entered into the regression analyses included age, sex, Charlson Comorbidity Index (CCI), smoking status, opioid use, upper vs. lower extremity injury, whether the original fracture was open or closed, bone defect>1 cm, previous treatment for deep infection, number of previous surgical interventions and time from original injury. One hundred and four patients were enrolled in the trial and 96 had completed the baseline assessment and were included in the analysis. The mean age of the patients was 43 years (SD=13.4), 79% were male (76/96), 24% were current smokers (23/96), and in 52% of patients (50/96) the original injury was an open fracture. At baseline, 49% of patients (47/96) reported they were currently unemployed or disabled and 27% reported using opioid medications (26/96). At baseline, the mean SMFA function score was 38 points (SD=16), the mean PCS score was 33.8 (SD=7.9) and the mean MCS score was 48.1 (SD=11.4). The results of the regression analyses did not identify any variables that were independently associated with function or quality of life at baseline. In this study we did not find any patient or injury characteristics that were associated with worse function or quality of life at baseline. Overall, patients presenting with a non-union or bone defect demonstrated high levels of dysfunction and disability as well as significantly impaired quality of life compared to population norms (SMFA normative ‘uninjured’ mean = 12.7, US population mean SF-12 PCS = 50). These results highlight the significant disability and impaired quality of life experienced by patients presenting with a long bone non-union and the importance of continued research to optimize outcomes in these patients.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».