Treatment outcomes determine patient satisfaction after lower extremity trauma

O'Toole RV, Castillo RC, Pollak AN, et al, University of Maryland School of Medicine and Johns Hopkins Bloomberg School ofPublic Health, Baltimore. Determinants of patient satisfactionafter severe lower-extremity injuries. J Bone Joint Surg. 2008;90A:1206-1211.

Patient satisfaction after high-energy lower extremity trauma is associated with treatment outcomes, especially physical function, pain, depression, and the ability to return to work. Satisfaction is not predetermined by the nature of the injury, underlying psychological or socioeconomic characteristics, or details and timing of surgery.

O'Toole and colleagues conducted a secondary analysis of Lower Extremity Assessment Project study data for 463 patients who were treated for limbthreatening lower extremity injuries. At 24 months after injury, participants underwent a clinical evaluation that included questions about their perceptions of surgery outcomes. Tested outcomes included pain, range of motion, muscle strength, depression, and scores of the Sickness Impact Profile (SIP). Tested patient characteristics included age, sex, and education.

At 2 years, 66% of participants were satisfied with their overall outcomes. No patient demographic, treatment, or injury characteristics were significantly associated with patient satisfaction; the only factors that correlated were measures of physical function, psychological distress, clinical recovery, and return to work. Outcome measures associated with more satisfaction were return to work, absence of depression, a better physical function score on the SIP, and less pain.

The authors noted that satisfaction may have more impact on future medical decision making.