Factors associated with satisfaction in patients undergoing elbow surgery: A prospective study

Hypothesis: Evidence on factors associated with patient satisfaction with elbow surgery is sparse; outcomes of surgery are not necessarily related to patient satisfaction. This study explored the hypothesis that condition-specific outcome measures would more closely reflect patient satisfaction than generic measures. Materials and methods: The prospective cohort comprised 104 consecutive patients/elbows undergoing elbow surgery. Preoperative and 6 month postoperative outcome questionnaires included the Oxford Elbow Score (OES), Disabilities of the Arm, Shoulder and Hand (DASH), and Short Form (SF)-36 general health survey. Clinical assessments used the standard Mayo Elbow Performance Score (MEPS). Patients who were "very pleased" with surgery were compared with others regarding which factors were associated with being "very pleased" at 6 months after surgery. Results: By 6 months, 54% of patients were very pleased with their surgery. Preoperative scores were generally not associated with subsequent patient satisfaction. Postoperative scores and change scores for the OES Pain and Social-Psychological scales and the DASH were moderately to highly correlated with patient satisfaction (r(s), -0.43 to -0.72; all P < .001), whereas SF-36 and MEPS change scores were only correlated to a small extent (r <= 0.34; all P < .05). A multivariable analysis revealed that patients' age, postoperative elbow pain, and change in elbow function each independently influenced the odds of patients being very pleased with surgery. Discussion: Associations between outcome measures and patient satisfaction revealed likely differences between patients' and clinicians' perceptions of which aspects of outcome rated as important. Conclusions: Patient-reported results are more likely than clinically assessed outcome measures, and condition-specific are more likely than generic measures, to reflect patient-rated satisfaction with elbow surgery. Level of evidence: Level II, Prospective Cohort, Treatment Study. (C) 2010 Journal of Shoulder and Elbow Surgery Board of Trustees.