PMID- 38464455
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240312
IS  - 2666-6383 (Electronic)
IS  - 2666-6383 (Linking)
VI  - 8
IP  - 2
DP  - 2024 Mar
TI  - Arthroscopic subacromial decompression improved outcomes in situationally 
      depressed patients compared to clinically depressed or nondepressed patients.
PG  - 304-309
LID - 10.1016/j.jseint.2023.11.012 [doi]
AB  - BACKGROUND: The purpose of this study is to evaluate patient reported outcomes 
      after arthroscopic extensive debridement 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.
CI  - (c) 2023 The Authors.
FAU - Greif, Dylan N
AU  - Greif DN
AD  - University of Rochester Department of Orthopaedics and Physical Rehabilitation, 
      Rochester, NY, USA.
FAU - Shaikh, Hashim J F
AU  - Shaikh HJF
AD  - University of Rochester Department of Orthopaedics and Physical Rehabilitation, 
      Rochester, NY, USA.
FAU - Neumanitis, James
AU  - Neumanitis J
AD  - University of Rochester Department of Orthopaedics and Physical Rehabilitation, 
      Rochester, NY, USA.
FAU - Ramirez, Gabriel
AU  - Ramirez G
AD  - University of Rochester Department of Orthopaedics and Physical Rehabilitation, 
      Rochester, NY, USA.
FAU - Maloney, Michael D
AU  - Maloney MD
AD  - University of Rochester Department of Orthopaedics and Physical Rehabilitation, 
      Rochester, NY, USA.
FAU - Bronstein, Robert D
AU  - Bronstein RD
AD  - University of Rochester Department of Orthopaedics and Physical Rehabilitation, 
      Rochester, NY, USA.
FAU - Giordano, Brian
AU  - Giordano B
AD  - University of Rochester Department of Orthopaedics and Physical Rehabilitation, 
      Rochester, NY, USA.
FAU - Nicandri, Gregg T
AU  - Nicandri GT
AD  - University of Rochester Department of Orthopaedics and Physical Rehabilitation, 
      Rochester, NY, USA.
FAU - Voloshin, Ilya
AU  - Voloshin I
AD  - University of Rochester Department of Orthopaedics and Physical Rehabilitation, 
      Rochester, NY, USA.
FAU - Mannava, Sandeep
AU  - Mannava S
AD  - University of Rochester Department of Orthopaedics and Physical Rehabilitation, 
      Rochester, NY, USA.
LA  - eng
PT  - Journal Article
DEP - 20231214
PL  - United States
TA  - JSES Int
JT  - JSES international
JID - 101763461
PMC - PMC10920123
OTO - NOTNLM
OT  - Arthroscopy
OT  - Depression
OT  - PROMIS
OT  - Patient reported outcomes
OT  - Shoulder
OT  - Subacromial decompression
OT  - Surgery
EDAT- 2024/03/11 06:44
MHDA- 2024/03/11 06:45
PMCR- 2023/12/14
CRDT- 2024/03/11 04:35
PHST- 2024/03/11 06:45 [medline]
PHST- 2024/03/11 06:44 [pubmed]
PHST- 2024/03/11 04:35 [entrez]
PHST- 2023/12/14 00:00 [pmc-release]
AID - S2666-6383(23)00283-9 [pii]
AID - 10.1016/j.jseint.2023.11.012 [doi]
PST - epublish
SO  - JSES Int. 2023 Dec 14;8(2):304-309. doi: 10.1016/j.jseint.2023.11.012. 
      eCollection 2024 Mar.