Portal de Periódicos da CAPES

Predicting Outcomes After Distal Radius Fracture: A 24-Center International Clinical Trial of Older Adults

2019; Elsevier BV; Volume: 44; Issue: 9 Linguagem: Inglês

10.1016/j.jhsa.2019.05.016

1531-6564

Kevin C. Chung, Hyungjin Myra Kim, Sunitha Malay, Melissa J. Shauver, Kevin C. Chung, Hyungjin Myra Kim, Steven C. Haase, Jeffrey N. Lawton, John R. Lien, Adeyiza O. Momoh, Kağan Özer, Erika D. Sears, Jennifer F. Waljee, Matthew S. Brown, Hoyune E. Cho, Brett F. Michelotti, Sunitha Malay, Melissa J. Shauver, Tamara D. Rozental, Paul Appleton, Edward K. Rodriguez, Laura N. Deschamps, Lindsay Mattfolk, Katiri Wagner, Philip Blazar, Brandon E. Earp, Waldo E. Floyd, Dexter Louie, Fraser J. Leversedge, Marc J. Richard, David S. Ruch, Suzanne Finley, Cameron Howe, Maria Manson, Janna Whitfield, Bertrand H. Perey, Kelly Apostle, Dory Boyer, Farhad Moola, Trevor Stone, Darius G. Viskontas, Mauri Zomar, Karyn Moon, Raely Moon, Loree K. Kalliainen, Christina M. Ward, James W. Fletcher, Cherrie A. Heinrich, Katharine S. Pico, Ashish Mahajan, Brian W. Hill, Sandy Vang, Dawn M. LaPorte, Erik A. Hasenboehler, Scott D. Lifchez, Greg Osgood, Babar Shafiq, Jaimie T. Shores, Vaishali Laljani, H. Brent Bamberger, Timothy W. Harman, David Martineau, Carla Robinson, Brandi Palmer, Ruby Grewal, Ken A. Faber, Joy C. MacDermid, Kate Kelly, Katrina Munro, Joshua I. Vincent, David Ring, Jesse B. Jupiter, Abigail Finger, Jillian S. Gruber, Rajesh Reddy, Taylor M. Pong, Emily R. Thornton, David G. Dennison, Sanjeev Kakar, Marco Rizzo, Alexander Y. Shin, Tyson L. Scrabeck, Kyle J. Chepla, Kevin J. Malone, Harry A. Hoyen, Blaine T. Bafus, Roderick B. Jordan, Bram R. Kaufman, Ali Totonchil, Dana R. Hromyak, Lisa Humbert, Sandeep J. Sebastin, Sally Tay, Kate W. Nellans, Sara L. Merwin, Ethan W. Blackburn, Sandra J. Hanlin, Barbara J. Patterson, R. Glenn Gaston, R. Christopher Cadderdon, Erika Gordon Gantt, J. Stuart Gaul, Daniel R. Lewis, Bryan J. Loeffler, Lois K. Osier, Paul C. Perlik, William Alan Ward, Benjamin Connell, Pricilla Haug, Caleb Michalek, Tod A. Clark, Sheila McRae, Jennifer Moriatis Wolf, Craig M. Rodner, Katy Coyle, Thomas P. Lehman, Yuri C. Lansinger, Gavin O’Mahony, Kathy Carl, Janet Wells, David J. Bozentka, L. Scott Levin, David Steinberg, Annamarie D. Horan, Denise Knox, Kara Napolitano, John R. Fowler, Robert J. Goitz, Cathy A. Naccarelli, Joelle Tighe, Warren C. Hammert, Allison W. McIntyre, Krista L. Noble, Kaili Waldrick, Jeffery Friedrich, David Bowman, Angela Wilson, Zhongyu Li, L. Andrew Koman, Benjamin R. Graves, Beth P. Smith, Debra Bullard,

Elbow and Forearm Trauma Treatment

Current evidence on predictors of outcomes after distal radius fracture is often based on retrospective analyses or may be confounded by fracture type. Using data from the Wrist and Radius Injury Surgical Trial (WRIST), a 24-site randomized study of distal radius fracture treatment, in which all fractures are severe enough to warrant surgery, we set out to perform a secondary data analysis to explore predictors of better or worse hand outcomes.The primary outcome measure was the Michigan Hand Outcomes Questionnaire (MHQ) summary score 12 months after treatment. We used a regression tree analysis with recursive partitioning to identify subgroups of participants who experienced similar outcomes (ie, MHQ score) and to determine which baseline or treatment factors they had in common.Factors most predictive of 12-month MHQ score were pain at enrollment, education, age, and number of comorbidities. Specifically, participants who had a high school education or less and also reported severe pain had the lowest MHQ scores. Conversely, participants with less pain and more education and who were age 87 years or younger with one or no comorbid condition had the highest MHQ scores. Treatment type or radiographic measurements assessed on post-reduction films did not affect 12-month outcomes.These results identified patient characteristics that can be used by surgeons to identify subgroups of patients who may experience similar hand outcomes.Prognostic III.