The Impact of Brachial Plexus Injury on Quality of Life
Gabriella Margaret Brown, BS; Chapel Hill, NC; Carrie Bettlach, FNP; Susan E. Mackinnon, MD; Amy M Moore, MD
Washington University School of Medicine, Saint Louis, MO
Brachial plexus injuries (BPI) have a tremendous impact on patients' well-being. In this study, we (1) investigated the psychological impact and quality of life (QOL) of patients with BPI treated surgically over the time-course of recovery and (2) assessed the impairment of QOL in relation to age, sex, work status, disability, and upper-extremity function-return in patients with BPI.
A retrospective chart review was conducted using records of patients who underwent BPI surgical treatment between 2012 and 2017. At the time of initial patient contact and during each subsequent visit, patients completed the validated Pain and Quality of Life questionnaire and the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire. Data points were extracted from these completed forms, and the resulting data set was used to track and compare QOL data over time. Patient demographics, injury location, mechanism, procedures performed, and functional outcomes were also reviewed.
Patients with surgically treated BPI experienced higher levels of depression, anxiety, and pain during the early post-operative period (< 6months) in comparison to a later time period (> 6 months) when recovery is expected and on-going. Greater detriment in QOL was observed in patients with less functional recovery than those with higher functional recovery.
Over the time course of recovery there are predictable decreases in QOL which improve with time and return of function. Toward the end goal of delivering the highest quality care possible to our patients, we believe it is imperative to study the effects of BPI and associated surgical treatment beyond assessment of physical function. This study makes headway in that regard, by quantifying effects on QOL post-surgery.
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