title: The patient-based outcome of upper-extremity surgeries using the DASH questionnaire and the effect of disease activity of the patients with rheumatoid arthritis.
abstract: The Disabilities of the Arm, Shoulder and Hand (DASH) is a standardized patient-based outcome measure, which assesses integrated upper-extremity disorders. The objectives of this study were to investigate subjective outcome after upper-extremity surgeries for the patients with rheumatoid arthritis (RA) using the DASH questionnaire (Japanese version) and to investigate the influence of disease activity on the surgical outcome using the Disease Activity Score (DAS) 28-CRP(4). Approximately 127 surgical procedures for the upper extremities in 127 patients with RA were recruited in this study. Surgeries were performed in 4 shoulders, 35 elbows, 60 wrists and 28 hands. The DASH score (disability/symptom score) was investigated just before surgery and at follow-up. The mean follow-up period after the surgery was 15 months on average (range, 6 to 24 months). The preoperative DASH score (disability/symptom score) 50 +/- 23 (mean +/- SD) decreased significantly to 38 +/- 23 at the follow-up (n = 127, p < 0.01). Standardized response mean and effect size revealed a medium effect of -0.6 and -0.5. Patients with various degrees of disease activity improved and the improvements per se were comparable of preoperative disease activity and postoperative response to medical treatment. A favorable subjective outcome of rheumatoid upper-extremity surgeries can be anticipated under the good control of disease activity.
authors.affiliation: Deparment of Rheumatology, Niigata Rheumatic Center, 1-2-8 Honcho, Shibata City, Niigata, Japan. med@ra-center.com
authors.forename: Hajime
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Akira
authors.initials: A
authors.lastname: Murasawa
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Nakazono
authors.forename: Asami
authors.initials: A
authors.lastname: Abe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Otani
authors.forename: Tahahiro
authors.initials: T
authors.lastname: Netsu
authors.forename: Takehito
authors.initials: T
authors.lastname: Sakai
authors.forename: Hiroe
authors.initials: H
authors.lastname: Sato
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012720:Severity of Illness Index; D034941:Upper Extremity / Q000601:surgery*