Role of Preoperative PROMIS Scores in Predicting Postoperative Outcomes and Likelihood of Achieving MCID Following Reverse Shoulder Arthroplasty

Document Type

Conference Proceeding

Publication Date

7-1-2021

Abstract

Aim: The purpose of this study was to investigate the influence of preoperative PROMIS scores in predicting postoperative PROMIS scores and the likelihood of achieving a minimal clinically important difference (MCID) following primary reverse total shoulder arthroplasty for cuff tear arthropathy. Background: The patient-reported outcomes measurement information system (PROMIS) has emerged as an efficient and valid outcome measure in various shoulder surgeries. When determining if a surgery was successful, surgeons may look for meaningful improvements in various health measures. One method to demonstrate these improvements is through the minimal clinically important difference (MCID).We hypothesize that pre-operative PROMIS scores will influence both post-operative PROMIS scores and the probability of achieving MCID. Methods: Patients undergoing reverse shoulder arthroplasty by a board-certified shoulder and elbow surgeon were given three PROMIS CAT forms: PROMIS Upper Extremity Physical Function CAT v2.0 (“PROMIS-UE”), PROMIS Pain Interference v1.1 (“PROMIS-PI”), and PROMIS Depression v1.0 (“PROMIS-D”). Several patient-centric demographics were also collected, such as age, sex, ethnicity, smoking status, employment status, and zip code. Results: Our cohort consisted of 36 male patients (49.3%) and an average age of 69.7 years (standard deviation, 11.9). Mean follow-up time point was 9.6 months (standard deviation, 5.0) after surgery. Preoperative PROMIS-UE, PROMIS-PI, and PROMIS-D were 29.5 ± 6.2, 63.3 ± 5.4, and 50.1 ± 9.2, respectively. Each domain significantly improved at 6-months to 40.9 ± 7.8, 51.4 ± 8.5, 42.6 ± 8.1, respectively. Following the ndistribution-based method for MCID calculation, we found the following MCID values for PROMIS-UE, PROMIS-PI, and PROMIS-D: 3.1, 2.7, and 4.6, respectively. ROC analysis revealed strong predictive ability for PROMIS-UE (AUC = 0.717, p < 0.05), moderative predictive ability for PROMIS-PI (AUC = 0.634, p < 0.05), and excellent predictive ability for PROMIS-D (AUC = 0.864, p < 0.05). Specifically, cutoff values of <26.0, >70.0, and >52.5 for PROMIS-UE, PROMIS-PI, and PROMIS-D are especially predictive of achieving MCID. Conclusions: Preoperative baseline scores can serve as strong predictors of success in patients undergoing primary reverse shoulder arthroplasty and can be used to both counsel patients on surgery and to tailor postoperative protocols.

PubMed ID

Not assigned.

Issue

7

First Page

e430

Last Page

e431

This document is currently not available here.

Share

COinS