Minimal Clinically Important Difference and Patient Acceptable Symptom State for the Pittsburgh Sleep Quality Index in Patients Who Underwent Rotator Cuff Tear Repair.

The Pittsburgh Sleep Quality Index (PSQI) is a valid patient-reported outcome measure developed to assess sleep quality and disturbances in clinical populations. This study aimed to calculate the minimum clinically important difference (MCID) and the patient acceptable symptom state (PASS) for the PSQI in patients who underwent rotator cuff repair (RCR). Preoperative and six-month postoperative follow-up questionnaires were completed by 50 patients (25 males and 25 females, mean age 58.7 ± 11.1 years). The MCID of the PSQI was calculated using distribution-based and anchor methods. To calculate the PSQI's PASS, the 75th percentile approach and the receiver operating characteristic (ROC) curve were used. The MCID from preoperative to 6 months postoperative follow-up is 4.4. Patients who improved their PSQI score of 4.4 from baseline to 6 months follow-up had a clinically significant increase in their health status. The PASS is 5.5 for PSQI; therefore, a value of PSQI at least 5.5 at six months follow-up indicates that the symptom state can be considered acceptable by most patients.

Arthroscopic Rotator Cuff Repair Improves Sleep Disturbance and Quality of Life: A Prospective Study.

Sleep disturbances are very common in patients with rotator cuff injury. Improvement of sleep quality in these patients can be considered a significant factor for healing in conjunction with surgery. The primary objective of this prospective study was to evaluate changes in sleep quality after surgery in patients with rotator cuff repair by analyzing the PSQI (Pittsburgh Sleep Quality Index) score. The secondary aim was to evaluate the improvement in quality of life in terms of functional limitations and shoulder pain after surgery. Fifty-eight patients with rotator cuff tears treated by arthroscopic surgery were included. All the patients completed the PSQI, the 36-Item Short Form Survey (SF-36), the Simple Shoulder Test (SST), the American Shoulder and Elbow Surgeons Shoulder Score (ASES), the Oxford Shoulder Score (OSS) and the Constant-Murley Score (Constant) before and at one, three and six months after surgery. Overall improvement in all the scores analyzed (p < 0.001) was found. Preoperative and postoperative PSQI scores correlated with SF-36, SST, ASES and Constant scores at each follow-up. Preoperative and one-month postoperative OSS correlated with the PSQI score. Using the Friedman test, we found an overall improvement in all score analyses (p < 0.001). The results prove that after rotator cuff repair, sleep disturbances improve three to six months after surgery improving the quality of life of these patients.