Clinical and radiological factors associated with postoperative shoulder imbalance and correlation with patient-reported outcomes following scoliosis surgery

ObjectivesTo compare the degrees to which 8 domains of health are affected across types of cerebrovascular events and to identify factors associated with domain scores in different event types.MethodsThis was an observational cohort study of 2,181 patients with ischemic stroke, intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), or TIA in a cerebrovascular clinic from February 17, 2015, to June 2, 2017 who completed Quality of Life in Neurologic Disorders executive function and the following Patient-Reported Outcomes Measurement Information System scales as part of routine care: physical function, satisfaction with social roles, fatigue, anxiety, depression, pain interference, and sleep disturbance.ResultsAll health domains were affected to similar degrees in patients with ICH, SAH, and ischemic stroke after adjustment for disability and other clinical factors, whereas patients with TIA had worse adjusted scores for 5 of the 8 domains of health. Female sex, younger age, lower income, and event <90 days were associated with worse scores in multiple domains. Factors associated with health domain scores were similar for all cerebrovascular events. Most affected domains for all were physical function, satisfaction with social roles, and executive function.ConclusionsThe subtype of stroke (ischemic stroke, ICH, and SAH) had similar effects in multiple health domains, while patients with TIA had worse adjusted outcomes, suggesting that the mechanisms for outcomes after TIA may differ from those of other cerebrovascular events. The most affected domains across all event types were physical function, satisfaction with social roles, and executive function, highlighting the need to develop effective interventions to improve these health domains in survivors of these cerebrovascular events.

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Fulcrum flexibility of the main curve predicts postoperative shoulder imbalance in selective thoracic fusion of adolescent idiopathic scoliosis

European Spine Journal ◽

10.1007/s00586-018-5669-y ◽

2018 ◽

Vol 27 (9) ◽

pp. 2251-2261 ◽

Cited By ~ 4

Author(s):

Soren Ohrt-Nissen ◽

Vijay H. D. Kamath ◽

Dino Samartzis ◽

Keith Dip Kei Luk ◽

Jason Pui Yin Cheung

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Selective Thoracic Fusion ◽

Postoperative Shoulder Imbalance ◽

Shoulder Imbalance ◽

Postoperative Shoulder ◽

Main Curve

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Patient-Reported Outcomes and Factors Associated with Achieving the Minimal Clinically Important Difference After ACL Reconstruction

JBJS Open Access ◽

10.2106/jbjs.oa.21.00056 ◽

2021 ◽

Vol 6 (4) ◽

Author(s):

Benedict U. Nwachukwu ◽

Spencer W. Sullivan ◽

Ryan C. Rauck ◽

Evan W. James ◽

Joost A. Burger ◽

...

Keyword(s):

Acl Reconstruction ◽

Patient Reported Outcomes ◽

Minimal Clinically Important Difference ◽

Factors Associated ◽

Clinically Important Difference ◽

Patient Reported

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Factors Associated with Improvement in Patient-reported Outcomes after Receiving Early Palliative Care

10.26226/morressier.5c76c8b5e2ea5a72376120d8 ◽

2019 ◽

Author(s):

Rebecca Rodin ◽

Camilla Zimmermann ◽

Ashley Pope ◽

Nadia Swami ◽

Breffni Hannon ◽

...

Keyword(s):

Palliative Care ◽

Patient Reported Outcomes ◽

Early Palliative Care ◽

Factors Associated ◽

Patient Reported

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Capturing the patient voice in radiotherapy trials: An analysis of trends and future directions of patient-reported outcomes.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.5_suppl.216 ◽

2017 ◽

Vol 35 (5_suppl) ◽

pp. 216-216

Author(s):

Noelle L. Williams ◽

Ayesha Ali ◽

Tu Dan ◽

Kyle Ziemer ◽

Benjamin E. Leiby ◽

...

Keyword(s):

Digital Literacy ◽

Patient Reported Outcomes ◽

Cost Of Care ◽

Phase Iii ◽

Published Data ◽

Cooperative Groups ◽

Factors Associated ◽

Patient Reported ◽

Chi Squared

216 Background: The importance of patient-reported outcomes (PROs) has been recognized and this data is increasingly being incorporated into modern radiotherapy (RT) trial design. Despite this, there is a lack of published data regarding collection and reporting of PRO data in the RT setting. We sought to systematically evaluate RT protocols to assess trends of PRO data collection and factors associated with reporting. Methods: We queried multi-institutional RT trials indexed on ClinicalTrials.gov, the Cochrane database, and MEDLINE and identified trials with full protocols available. We collected information in regards to study population, primary and secondary endpoints, quality of life measures, and PRO data. Descriptive and chi-squared analyses were employed to investigate trends and factors associated with PRO reporting. Results: 232 protocols were evaluable (1971-2014) from multiple cooperative groups. Of these, 198 were completed and 34 were in progress. Overall, only 41% of trials had protocol-specified collection of PROs. Of the 155 trials that had at least 1 published report, only 34 (22%) reported PRO data. All nine trials with PRO as a primary endpoint (9/9) had published reports with this information. Treatment era was associated with PRO collection, with 30% of trials collecting PRO data prior to 2005, 48% between 2006 and 2010, and 66% between 2011 and 2015 ( X2 [4, N = 232] = 15.79, p = 0.003). PROs were most likely to be collected in phase III trials ( X2 [4, N = 226] = 59.6, p < 0.0001). Conclusions: PROs are historically under collected and reported in cooperative group RT trials. Despite increasing PRO collection in modern trials, reporting remains suboptimal and may inaccurately inform survivorship issues. As digital literacy progresses, electronic PRO data may offer a potential avenue for improvement. Ultimately, PRO data will serve as a vital component to help define value in newly proposed payment models focused on improving quality of care while reducing cost of care.

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Analysis of Preoperative and Operative Factors Influencing Postoperative Shoulder Imbalance in Lenke Type 1 Adolescent Idiopathic Scoliosis

Zeitschrift für Orthopädie und Unfallchirurgie ◽

10.1055/a-1337-3435 ◽

2021 ◽

Cited By ~ 1

Author(s):

Clara Berlin ◽

Markus Quante ◽

Esther Freifrau von Richthofen ◽

Henry Halm

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Lumbar Curve ◽

Curve Correction ◽

Postoperative Shoulder Imbalance ◽

Shoulder Imbalance ◽

Shoulder Position ◽

Postoperative Shoulder ◽

Shoulder Elevation

Abstract Background Postoperative shoulder imbalance is a common complication in adolescent idiopathic scoliosis and may impair patient satisfaction. The little data in the literature on the prediction and treatment of postoperative shoulder imbalance is incongruous. According to some studies, postoperative shoulder imbalance depends on the superior instrumented vertebral bodies, skeletal maturity, extent of correction and flexibility of the major curve. Question Can preoperative radiological parameters from X-ray and traction films as well as correction of the curves be used to identify a factor impacting on postoperative shoulder imbalance? Material and Methods Prospective data in adolescent idiopathic scoliosis with thoracic curve (Lenke type 1), operated on between 2015 and 2018 at a scoliosis centre, were analysed retrospectively based on full-length X-rays of the spine (pre-/postOP and follow-up (FU)) and preoperative-traction films: age; correction of proximal, main and lumbar curve; shoulder height [mm]; clavicle angle [°]; T1 tilt [°]; coronal plumb line deviation [mm]. The findings were expressed as means with standard deviation. Changes in parameters over time (postOP-FU) were compared by t test (significance level α = 0.05). The correlation between preOP parameters and extent of correction with postoperative shoulder imbalance (≥ 15 mm) was determined by Pearson correlation and regression classification analysis. Outcomes 55 patients with adolescent idiopathic scoliosis, mean age of 15 ± 1.4 years. The FU-rate after a mean of 15 months was 80% (n = 44). Correction of proximal, main and lumbar curve: 47.0%, 75.8% and 68.8%, respectively, without statistically significant change (Δ) in FU (p > 0.05). Shoulder height was − 11.0 ± 12.7 mm (preOP), 15.5 ± 13.4 mm (postOP), 10.1 ± 10.6 mm (FU) (p < 0.05). 38% of those with adolescent idiopathic scoliosis had preOP right shoulder elevation; 55% (postOP) and 32% (FU) respectively had postoperative shoulder imbalance (left shoulder elevation). Strong statistical correlation was found for Δshoulder position (FU-preOP) with pre-OP shoulder position (r = − 0.7), and Δshoulder position (pre-OP traction films) (r = 0.5) with pre-OP clavicle angle (r = − 0.5). On regression classification analysis, 81.8% of cases did display postoperative shoulder imbalance if proximal curve correction was ≤ 64.4%; main and lumbar curve correction, Δshoulder elevation (preOP traction films) played a secondary role. Discussion One common complication even in Lenke type 1 adolescent idiopathic scoliosis is postoperative shoulder imbalance. Preoperative planning should include traction films, preoperative shoulder position and clavicle angle to avoid postoperative shoulder imbalance. Moderate correction of proximal curve is critical for postoperative shoulder balance.

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