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Associations between clinical diagnostic criteria and pretreatment patient-reported outcomes measures in a prospective observational cohort of patients with neurogenic thoracic outlet syndrome.

Abstract Neurogenic thoracic outlet syndrome (NTOS) is caused by dynamic compression of the brachial plexus at the level of the supraclavicular scalene triangle or the subcoracoid (pectoralis minor) space, or both. The purpose of this study was to characterize relationships between 14 clinical diagnostic criteria (CDC) and seven pretreatment patient-reported outcomes measures (PROMs) in a prospective cohort of patients with NTOS.
PMID
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Authors

Mayor MeshTerms

Disability Evaluation

Pain Measurement

Patient Reported Outcome Measures

Quality of Life

Keywords
Journal Title journal of vascular surgery
Publication Year Start




PMID- 28735950
OWN - NLM
STAT- MEDLINE
DA  - 20170724
DCOM- 20170731
LR  - 20170731
IS  - 1097-6809 (Electronic)
IS  - 0741-5214 (Linking)
VI  - 66
IP  - 2
DP  - 2017 Aug
TI  - Associations between clinical diagnostic criteria and pretreatment
      patient-reported outcomes measures in a prospective observational cohort of
      patients with neurogenic thoracic outlet syndrome.
PG  - 533-544.e2
LID - S0741-5214(17)31062-5 [pii]
LID - 10.1016/j.jvs.2017.03.419 [doi]
AB  - OBJECTIVE: Neurogenic thoracic outlet syndrome (NTOS) is caused by dynamic
      compression of the brachial plexus at the level of the supraclavicular scalene
      triangle or the subcoracoid (pectoralis minor) space, or both. The purpose of
      this study was to characterize relationships between 14 clinical diagnostic
      criteria (CDC) and seven pretreatment patient-reported outcomes measures (PROMs) 
      in a prospective cohort of patients with NTOS. METHODS: There were 183 new
      patient referrals between July 1 and December 31, 2015, with 150 (82%) meeting an
      established set of predefined CDC for NTOS. PROMs were evaluated across five
      domains: pain severity, functional disability, depression, quality of life, and
      pain catastrophizing. Linear regression and Pearson correlation statistics were
      used to analyze associations between CDC and PROMs. RESULTS: Mean +/- standard
      error patient age was 37.1 +/- 1.1 years (range, 12-66 years), and 107 (71%) were
      women. Five (3%) had a cervical rib, and 15 (10%) had recurrent NTOS. The most
      frequently positive CDC were neck or upper extremity pain (99%), upper extremity 
      or hand paresthesia (94%), symptom exacerbation by arm elevation (97%), localized
      supraclavicular or subcoracoid tenderness to palpation (96%), and a positive
      3-minute elevated arm stress test (94%; mean duration, 102.0 +/- 5.1 seconds).
      The number of positive CDC (mean, 9.6 +/- 0.1) correlated with the degree of
      tenderness to palpation and the duration of elevated arm stress test, as well as 
      with PROMs for pain severity, functional disability, depression, physical quality
      of life, and pain catastrophizing (all P < .0001). PROMs across multiple domains 
      were also strongly correlated with each other. Patients with clinically
      significant pain catastrophizing exhibited a greater level of functional
      disability than noncatastrophizing patients (P < .0001). CONCLUSIONS: This study 
      illustrates the relative strengths of 14 CDC and seven PROMs to evaluate patients
      with NTOS, helping validate the selected CDC and highlighting the potential role 
      of pain catastrophizing in functional disability. This cohort will provide
      valuable information on the utility of different CDC and PROMs to predict
      treatment outcomes.
CI  - Copyright (c) 2017 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Balderman, Joshua
AU  - Balderman J
AD  - Department of Surgery, Center for Thoracic Outlet Syndrome and the Section of
      Vascular Surgery, Washington University School of Medicine in St. Louis, St.
      Louis, Mo.
FAU - Holzem, Katherine
AU  - Holzem K
AD  - Department of Surgery, Center for Thoracic Outlet Syndrome and the Section of
      Vascular Surgery, Washington University School of Medicine in St. Louis, St.
      Louis, Mo.
FAU - Field, Beverly J
AU  - Field BJ
AD  - Division of Pain Management, Department of Anesthesiology, Washington University 
      School of Medicine in St. Louis, St. Louis, Mo; Department of Psychiatry,
      Washington University School of Medicine in St. Louis, St. Louis, Mo.
FAU - Bottros, Michael M
AU  - Bottros MM
AD  - Division of Pain Management, Department of Anesthesiology, Washington University 
      School of Medicine in St. Louis, St. Louis, Mo.
FAU - Abuirqeba, Ahmmad A
AU  - Abuirqeba AA
AD  - Department of Surgery, Center for Thoracic Outlet Syndrome and the Section of
      Vascular Surgery, Washington University School of Medicine in St. Louis, St.
      Louis, Mo.
FAU - Vemuri, Chandu
AU  - Vemuri C
AD  - Department of Surgery, Center for Thoracic Outlet Syndrome and the Section of
      Vascular Surgery, Washington University School of Medicine in St. Louis, St.
      Louis, Mo.
FAU - Thompson, Robert W
AU  - Thompson RW
AD  - Department of Surgery, Center for Thoracic Outlet Syndrome and the Section of
      Vascular Surgery, Washington University School of Medicine in St. Louis, St.
      Louis, Mo. Electronic address: [email protected]
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - J Vasc Surg
JT  - Journal of vascular surgery
JID - 8407742
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Catastrophization/*diagnosis/physiopathology/psychology
MH  - Child
MH  - Depression/*diagnosis/physiopathology/psychology
MH  - *Disability Evaluation
MH  - Female
MH  - Health Status
MH  - Humans
MH  - Male
MH  - Mental Health
MH  - Middle Aged
MH  - Missouri
MH  - Pain/*diagnosis/physiopathology/psychology
MH  - *Pain Measurement
MH  - *Patient Reported Outcome Measures
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Prospective Studies
MH  - *Quality of Life
MH  - Reproducibility of Results
MH  - Severity of Illness Index
MH  - Thoracic Outlet Syndrome/*diagnosis/physiopathology/psychology
MH  - Time Factors
MH  - Young Adult
EDAT- 2017/07/25 06:00
MHDA- 2017/08/02 06:00
CRDT- 2017/07/25 06:00
PHST- 2017/01/16 [received]
PHST- 2017/03/04 [accepted]
AID - S0741-5214(17)31062-5 [pii]
AID - 10.1016/j.jvs.2017.03.419 [doi]
PST - ppublish
SO  - J Vasc Surg. 2017 Aug;66(2):533-544.e2. doi: 10.1016/j.jvs.2017.03.419.