How Much Pain Is Significant? Defining the Minimal Clinically Important Difference for the Visual Analog Scale for Pain After Total Joint Arthroplasty.
J Arthroplasty
; 33(7S): S71-S75.e2, 2018 07.
Article
em En
| MEDLINE
| ID: mdl-29567002
ABSTRACT
BACKGROUND:
The ability to detect changes in patient-perceived pain after total joint arthroplasty (TJA) is critical to manage postoperative pain. The minimal clinically important difference (MCID) for visual analog scale for pain (VAS-P) has not been investigated in this population. This study investigated the MCID for VAS-P in the TJA population.METHODS:
Postoperative pain scores were collected on 139 total hip arthroplasty (THA) and 165 total knee arthroplasty (TKA) patients. VAS-P was measured and Likert scores for changes in pain recorded together throughout the hospitalization per patient. Using a linear mixed model, the mean difference between preceding and current VAS-P was calculated and correlated with Likert score, when the patient reported at least slight improvement or worsening in pain, defining the MCID. Minimal detectable change was calculated using the VAS-P standard error of the means for patients reporting "no change."RESULTS:
For THA, the overall mean and average highest VAS-P were 35.0 mm and 50.4 mm, respectively. For TKA, the overall mean and average highest VAS-P were 42.6 mm and 61.1 mm, respectively. The minimal detectable change in VAS-P was 14.9 mm for THA and 16.1 mm for TKA. The MCID for THA and TKA pain improvement was -18.6 mm and -22.6 mm, respectively, and for worsening was 23.6 mm and 29.1 mm, respectively.CONCLUSION:
In the postoperative TJA population, VAS-P MCID changes depend on the type of surgical intervention, and whether pain is improving or worsening. Statistically significant VAS-P, improving -18.6 mm and -22.6 mm for THA and TKA patients, respectively, sets a reasonable threshold to identify clinically meaningful pain intervention with high specificity.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Dor Pós-Operatória
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Medição da Dor
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Artroplastia de Quadril
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Artroplastia do Joelho
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Escala Visual Analógica
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Diferença Mínima Clinicamente Importante
Tipo de estudo:
Observational_studies
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Prognostic_studies
Limite:
Adolescent
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Adult
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Aged
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Aged80
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Child
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Child, preschool
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Arthroplasty
Assunto da revista:
ORTOPEDIA
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Panamá