Arthroscopic subacromial decompression improved outcomes in situationally depressed patients compared to clinically depressed or nondepressed patients
Background: The purpose of this study is to evaluate patient reported outcomes after arthroscopic extensive débridement of the shoulder with subacromial decompression (SAD) for subacromial impingement using the Patient-Reported Outcomes Measurement Information System (PROMIS) system and evaluate if...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | JSES International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666638323002839 |
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| author | Dylan N. Greif, MD Hashim J.F. Shaikh, BS James Neumanitis, MD Gabriel Ramirez, MS Michael D. Maloney, MD Robert D. Bronstein, MD Brian Giordano, MD Gregg T. Nicandri, MD Ilya Voloshin, MD Sandeep Mannava, MD, PhD |
| author_facet | Dylan N. Greif, MD Hashim J.F. Shaikh, BS James Neumanitis, MD Gabriel Ramirez, MS Michael D. Maloney, MD Robert D. Bronstein, MD Brian Giordano, MD Gregg T. Nicandri, MD Ilya Voloshin, MD Sandeep Mannava, MD, PhD |
| author_sort | Dylan N. Greif, MD |
| collection | DOAJ |
| description | Background: The purpose of this study is to evaluate patient reported outcomes after arthroscopic extensive débridement of the shoulder with subacromial decompression (SAD) for subacromial impingement using the Patient-Reported Outcomes Measurement Information System (PROMIS) system and evaluate if depression (Dep) (clinical or situational) impacts patients achieving a Minimal Clinically Important Difference (MCID). Methods: Preoperative PROMIS Physical function (PF), Mood, and Dep scores were obtained at the closest date prior to arthroscopic rotator cuff repair and postoperative scores were collected at every clinical visit thereafter. Final PROMIS score used for data analysis was determined by the patients final PROMIS value between 90 to 180 days. Clinical Dep was determined by patients having a formal diagnosis of “Depression or Major Depressive Disorder” at the time of their surgery. Situationally depressed patients, those without a formal diagnosis yet exhibited symptomatic depressive symptoms, were classified by having a PROMIS-Dep cutoff scores larger than 52.5. Results: A total of 136 patients were included for final statistical analysis. 13 patients had a clinical but not situational diagnosis of Dep, 86 patients were identified who had no instance of clinical or situational Dep (nondepressed). 35 patients were situationally depressed. All three cohorts demonstrated a significant improvement in postoperative PROMIS Dep, PI, and PF score relative to their preoperative value (P = .001). Situationally depressed patients achieved greater delta PROMIS-Dep compared to patients with major depressive disorder. Depressed patients had a higher chance of achieving MCID for PROMIS-Dep compared to nondepressed patients (P = .01). Logistic regression analysis demonstrated that underlying Dep did not alter the odds of obtaining MCID compared to nondepressed patients. Nonsmoking patients had significantly greater odds of achieving MCID for PF (P = .02). Discussion: Patients improved after undergoing SAD regardless of underlying Dep or depressive symptoms. Depressed patients exhibited greater change in PROMIS scores compared to nondepressed patients. Smoking remains a risk factor for postoperative outcomes in patients undergoing SAD for subacromial impingement. Identifying and counseling patients with underlying depressive symptoms without a formal major depressive disorder diagnosis may lead to improved outcomes. These findings may help guide clinicians in deciding who would benefit the most from this procedure. |
| first_indexed | 2024-03-07T22:00:32Z |
| format | Article |
| id | doaj.art-d8212d39a9244de2806ba0dc0473a431 |
| institution | Directory Open Access Journal |
| issn | 2666-6383 |
| language | English |
| last_indexed | 2024-03-07T22:00:32Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj.art-d8212d39a9244de2806ba0dc0473a4312024-02-24T04:55:38ZengElsevierJSES International2666-63832024-03-0182304309Arthroscopic subacromial decompression improved outcomes in situationally depressed patients compared to clinically depressed or nondepressed patientsDylan N. Greif, MD0Hashim J.F. Shaikh, BS1James Neumanitis, MD2Gabriel Ramirez, MS3Michael D. Maloney, MD4Robert D. Bronstein, MD5Brian Giordano, MD6Gregg T. Nicandri, MD7Ilya Voloshin, MD8Sandeep Mannava, MD, PhD9Corresponding author: Dylan N. Greif, M.D, University of Rochester Department of Orthopaedics and Physical Rehabilitation, 601 Elmwood Ave, Rochester, NY 14642, USA.; University of Rochester Department of Orthopaedics and Physical Rehabilitation, Rochester, NY, USAUniversity of Rochester Department of Orthopaedics and Physical Rehabilitation, Rochester, NY, USAUniversity of Rochester Department of Orthopaedics and Physical Rehabilitation, Rochester, NY, USAUniversity of Rochester Department of Orthopaedics and Physical Rehabilitation, Rochester, NY, USAUniversity of Rochester Department of Orthopaedics and Physical Rehabilitation, Rochester, NY, USAUniversity of Rochester Department of Orthopaedics and Physical Rehabilitation, Rochester, NY, USAUniversity of Rochester Department of Orthopaedics and Physical Rehabilitation, Rochester, NY, USAUniversity of Rochester Department of Orthopaedics and Physical Rehabilitation, Rochester, NY, USAUniversity of Rochester Department of Orthopaedics and Physical Rehabilitation, Rochester, NY, USAUniversity of Rochester Department of Orthopaedics and Physical Rehabilitation, Rochester, NY, USABackground: The purpose of this study is to evaluate patient reported outcomes after arthroscopic extensive débridement of the shoulder with subacromial decompression (SAD) for subacromial impingement using the Patient-Reported Outcomes Measurement Information System (PROMIS) system and evaluate if depression (Dep) (clinical or situational) impacts patients achieving a Minimal Clinically Important Difference (MCID). Methods: Preoperative PROMIS Physical function (PF), Mood, and Dep scores were obtained at the closest date prior to arthroscopic rotator cuff repair and postoperative scores were collected at every clinical visit thereafter. Final PROMIS score used for data analysis was determined by the patients final PROMIS value between 90 to 180 days. Clinical Dep was determined by patients having a formal diagnosis of “Depression or Major Depressive Disorder” at the time of their surgery. Situationally depressed patients, those without a formal diagnosis yet exhibited symptomatic depressive symptoms, were classified by having a PROMIS-Dep cutoff scores larger than 52.5. Results: A total of 136 patients were included for final statistical analysis. 13 patients had a clinical but not situational diagnosis of Dep, 86 patients were identified who had no instance of clinical or situational Dep (nondepressed). 35 patients were situationally depressed. All three cohorts demonstrated a significant improvement in postoperative PROMIS Dep, PI, and PF score relative to their preoperative value (P = .001). Situationally depressed patients achieved greater delta PROMIS-Dep compared to patients with major depressive disorder. Depressed patients had a higher chance of achieving MCID for PROMIS-Dep compared to nondepressed patients (P = .01). Logistic regression analysis demonstrated that underlying Dep did not alter the odds of obtaining MCID compared to nondepressed patients. Nonsmoking patients had significantly greater odds of achieving MCID for PF (P = .02). Discussion: Patients improved after undergoing SAD regardless of underlying Dep or depressive symptoms. Depressed patients exhibited greater change in PROMIS scores compared to nondepressed patients. Smoking remains a risk factor for postoperative outcomes in patients undergoing SAD for subacromial impingement. Identifying and counseling patients with underlying depressive symptoms without a formal major depressive disorder diagnosis may lead to improved outcomes. These findings may help guide clinicians in deciding who would benefit the most from this procedure.http://www.sciencedirect.com/science/article/pii/S2666638323002839ArthroscopySubacromial decompressionShoulderDepressionPROMISPatient reported outcomes |
| spellingShingle | Dylan N. Greif, MD Hashim J.F. Shaikh, BS James Neumanitis, MD Gabriel Ramirez, MS Michael D. Maloney, MD Robert D. Bronstein, MD Brian Giordano, MD Gregg T. Nicandri, MD Ilya Voloshin, MD Sandeep Mannava, MD, PhD Arthroscopic subacromial decompression improved outcomes in situationally depressed patients compared to clinically depressed or nondepressed patients JSES International Arthroscopy Subacromial decompression Shoulder Depression PROMIS Patient reported outcomes |
| title | Arthroscopic subacromial decompression improved outcomes in situationally depressed patients compared to clinically depressed or nondepressed patients |
| title_full | Arthroscopic subacromial decompression improved outcomes in situationally depressed patients compared to clinically depressed or nondepressed patients |
| title_fullStr | Arthroscopic subacromial decompression improved outcomes in situationally depressed patients compared to clinically depressed or nondepressed patients |
| title_full_unstemmed | Arthroscopic subacromial decompression improved outcomes in situationally depressed patients compared to clinically depressed or nondepressed patients |
| title_short | Arthroscopic subacromial decompression improved outcomes in situationally depressed patients compared to clinically depressed or nondepressed patients |
| title_sort | arthroscopic subacromial decompression improved outcomes in situationally depressed patients compared to clinically depressed or nondepressed patients |
| topic | Arthroscopy Subacromial decompression Shoulder Depression PROMIS Patient reported outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2666638323002839 |
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