Factors Associated with Operative Treatment of De Quervain Tendinopathy
- سال انتشار: 1394
- محل انتشار: مجله استخوان و جراحی عمومی، دوره: 3، شماره: 3
- کد COI اختصاصی: JR_TABO-3-3_009
- زبان مقاله: انگلیسی
- تعداد مشاهده: 242
نویسندگان
Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, Boston, USA Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, Boston, USA
Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, Boston, USA
Orthopedic Hand and Upper Extremity Service, Brigham and Women’s Hospital, Boston, USA
Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, Boston, USA
چکیده
Background: Geographic and doctor-to-doctor variations in care are a focus of quality and safety efforts in medicine. This study addresses factors associated with variation in the rate of operative treatment of de Quervain tendinopathy. Methods: We used a database including all patient encounters at ۲ large medical centers, to study the experience of ۱۰ hand surgeons and ۱ physiatrist working in a hand surgery office in the treatment of ۲,۵۱۳ patients with de Quervain tendinopathy over a ۱۲-year period. Survival analysis using the Kaplan-Meier method was used to compare surgery rates and time to surgery. Cox multivariable regression analysis was applied to identify factors associated with operative treatment. Results: One hundred ninety nine (۷.۹%) patients had surgery. The odds of operative treatment were ۱.۷ times greater after corticosteroid injection and varied more than ۱۰-fold among providers. There was substantial variation in the overall rate of surgery by provider. Corticosteroid injection delayed surgery slightly, but was associated with a higher rate of surgery. Conclusion: Providers have substantial influence on treatment of de Quervain tendinopathy. The use of decision aids and other methods that help involve the patient in decision-making merit investigation as interventions to help reduce doctor-to-doctor variation.کلیدواژه ها
Cortisone injection, De Quervain tendinopathy, Decision aid, Operative treatment, Variationاطلاعات بیشتر در مورد COI
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