PMID- 34746669
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240404
IS  - 2574-2167 (Electronic)
IS  - 2574-2167 (Linking)
VI  - 4
IP  - 3
DP  - 2021 Sep
TI  - Which general functional outcome measure does a better job of capturing change in 
      clinical status in pelvic and acetabular fracture patients? An analysis of 
      responsiveness over the first year of recovery.
PG  - e137
LID - 10.1097/OI9.0000000000000137 [doi]
LID - e137
AB  - OBJECTIVE: To compare the responsiveness of the Short Form-36 (SF-36) physical 
      component score (PCS) to the Short Musculoskeletal Function Assessment (SMFA) 
      dysfunction index (DI) in pelvic and acetabular fracture patients over multiple 
      time points in the first year of recovery. DESIGN: Prospective cohort study. 
      SETTING: Level 1 trauma center. PATIENTS/PARTICIPANTS: Four hundred seventy-three 
      patients with surgically treated pelvic and acetabular fractures (Orthopaedic 
      Trauma Association B or C-type pelvic ring disruption or acetabular fracture) 
      were enrolled into the center's prospective orthopaedic trauma database between 
      January 2005 and February 2015. Functional outcome data were collected at 
      baseline, 6 months, and 12 months. MAIN OUTCOME MEASUREMENTS: Evaluation was 
      performed using the SF-36 Survey and Short Musculoskeletal Function Assessment. 
      Responsiveness was assessed by calculating the standard response mean (SRM), the 
      minimal clinically important difference (MCID), and floor and ceiling effects. 
      RESULTS: Three hundred five patients had complete data for both outcome scores. 
      SF-36 PCS and SMFA DI scores showed strong correlation for all time intervals 
      (r = -0.55 at baseline, r = -0.78 at 6 months, and r = -0.85 at 12 months). The 
      SRM of the SF-36 PCS was greater in magnitude than the SRM of SMFA DI at all time 
      points; this was statistically significant between baseline and 6 months 
      (P < .001), but not between 6 and 12 months (P = .29). Similarly, the proportion 
      of patients achieving MCID in SF-36 PCS was significantly greater than the 
      proportion achieving MCID in SMFA DI between baseline and 6 months (84.6% vs 
      69.8%, P < .001), and between 6 and 12 months (48.5% vs 35.7%, P = .01). There 
      were no ceiling or floor effects found for SF-36 PCS at any time intervals. 
      However, 16.1% of patients achieved the highest level of functioning detectable 
      by the SMFA DI at baseline, along with smaller ceiling effects at 6 months (1.3%) 
      and 12 months (3.3%). CONCLUSIONS: SF-36 PCS is a more responsive measure of 
      functional outcome than the SFMA DI over the first year of recovery in patients 
      who sustain a pelvic ring disruption or acetabular fracture. This superiority was 
      found in using the SRM, proportion of patients meeting MCID, and ceiling effects. 
      Furthermore, the SF-36 PCS correlated with the more disease-specific SMFA DI. 
      LEVEL OF EVIDENCE: Prognostic Level II.
CI  - Copyright (c) 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf 
      of the Orthopaedic Trauma Association.
FAU - Ko, Sebastian J
AU  - Ko SJ
AD  - Department of Orthopaedics, Faculty of Medicine, University of British Columbia.
FAU - O'Brien, Peter J
AU  - O'Brien PJ
AD  - Department of Orthopaedics, Faculty of Medicine, University of British Columbia.
AD  - Division of Orthopaedic Trauma, Vancouver General Hospital, Vancouver Coastal 
      Health, Vancouver, British Columbia, Canada.
FAU - Broekhuyse, Henry M
AU  - Broekhuyse HM
AD  - Department of Orthopaedics, Faculty of Medicine, University of British Columbia.
AD  - Division of Orthopaedic Trauma, Vancouver General Hospital, Vancouver Coastal 
      Health, Vancouver, British Columbia, Canada.
FAU - Guy, Pierre
AU  - Guy P
AD  - Department of Orthopaedics, Faculty of Medicine, University of British Columbia.
AD  - Division of Orthopaedic Trauma, Vancouver General Hospital, Vancouver Coastal 
      Health, Vancouver, British Columbia, Canada.
FAU - Lefaivre, Kelly A
AU  - Lefaivre KA
AD  - Department of Orthopaedics, Faculty of Medicine, University of British Columbia.
AD  - Division of Orthopaedic Trauma, Vancouver General Hospital, Vancouver Coastal 
      Health, Vancouver, British Columbia, Canada.
LA  - eng
PT  - Journal Article
DEP - 20210726
PL  - United States
TA  - OTA Int
JT  - OTA international : the open access journal of orthopaedic trauma
JID - 101770383
PMC - PMC8568449
OTO - NOTNLM
OT  - Short Form-36 Survey
OT  - acetabular fracture
OT  - functional outcome scores
OT  - pelvis fracture
OT  - short musculoskeletal function assessment
OT  - unstable pelvic ring injury
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2021/11/09 06:00
MHDA- 2021/11/09 06:01
PMCR- 2021/07/26
CRDT- 2021/11/08 06:55
PHST- 2020/11/19 00:00 [received]
PHST- 2021/04/08 00:00 [revised]
PHST- 2021/04/28 00:00 [accepted]
PHST- 2021/11/08 06:55 [entrez]
PHST- 2021/11/09 06:00 [pubmed]
PHST- 2021/11/09 06:01 [medline]
PHST- 2021/07/26 00:00 [pmc-release]
AID - OTAI-D-20-00078 [pii]
AID - 10.1097/OI9.0000000000000137 [doi]
PST - epublish
SO  - OTA Int. 2021 Jul 26;4(3):e137. doi: 10.1097/OI9.0000000000000137. eCollection 
      2021 Sep.