Persistent iliac crest donor site pain: independent outcome assessment.
OBJECTIVE
This study objectively defines the incidence of donor site pain in an independent outcome analysis. In addition, this study identifies the significant discrepancies that are observed when independent outcome assessment results are compared with the incidences determined by review of the operating surgeon's documented findings.


METHODS
A review of patients who underwent iliac bone graft harvesting by a single neurosurgeon was conducted. The presence of iliac crest donor site pain, at a time remote from surgery, as determined by specific questioning and recorded in the neurosurgeon's written evaluation was compared with independent assessment findings obtained in structured telephone questionnaire interviews. During a 4-year period, 105 patients met the inclusion criteria. Both the operating surgeon' and independent interviewer's follow-up evaluations were completed for all study patients. Pain was classified into three categories, i.e., no pain, acceptable pain, or unacceptable pain. Patients were also asked to assess the severity of their donor site pain by using a visual analog scale. Statistical analyses comparing the incidences of iliac crest donor site pain in the operating surgeon's evaluations and the independent assessments were performed.


RESULTS
When evaluated at a time remote from surgery, the true incidence of iliac crest donor site pain after graft harvest procedures (34%) was significantly greater than previously appreciated by the neurosurgeon (8%). Although occasional or mild pain was observed for 31% of patients, only 3% of all patients experienced unacceptable pain.


CONCLUSIONS
Independent outcome assessment values should be provided to patients in preoperative discussions regarding donor site morbidity. Objective outcome analysis, based on independent observations, is crucial for the most accurate interpretation of perceptions of iliac crest donor site pain.
Heary
Robert F
RF
Department of Neurosurgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey, USA. heary@umdnj.edu
Schlenk
Richard P
RP
Sacchieri
Theresa A
TA
Barone
Dean
D
Brotea
Cristian
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation; D002908:Chronic Disease; D005260:Female; D006282:Health Personnel; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D015994:Incidence; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009493:Neurosurgery / Q000379:methods; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010146:Pain / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D010147:Pain Measurement; D011795:Surveys and Questionnaires; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*