Patients with Functional Somatic Syndromes--FM, IBS, Chronic Headaches, and Chronic Low Back Pain--Have Lower Outcomes... 2022 Masood et al

[Andy]

Full title: Patients with Functional Somatic Syndromes--Fibromyalgia, Irritable Bowel Syndrome, Chronic Headaches, and Chronic Low Back Pain--Have Lower Outcomes And Higher Opioid Usage And Cost After Shoulder And Elbow Surgery

Abstract

Purpose
To perform a systematic review assessing the relationship between functional somatic syndromes (FSSs) and patient-reported outcome measures (PROMs), post-operative opioid consumption, and hospitalization costs after shoulder and elbow surgery.

Methods
A systematic review of the PubMed and Web of Science databases was conducted according to PRISMA guidelines to identify all studies evaluating the effect of having at least 1 FSS (fibromyalgia, irritable bowel syndrome, chronic headaches, chronic low back pain) on outcomes after shoulder and elbow surgeries. Outcomes of interest included postoperative analgesic use, patient reported outcome measures (PROMs), and hospitalization costs.

Results
The review identified a total of 320 studies, of which 8 studies met the inclusion criteria. The total number of participants in our 8 included studies was 57,389. Three studies (n=620) reported PROMs. These studies demonstrated that the presence of at least one FSS is predictive of significantly higher pain scores and lower quality of recovery, DASH, ASES, and SANE scores postoperatively. Although scores were inferior in among patients with FSS, two of the three studies showed improvement in PROMs in this group of patients. Seven studies (n= 56,909) reported postoperative opioid use. Of these, 5 reported that a diagnosis of at least one FSS was a strong risk factor for long-term opioid use after surgery. One study (n= 480) found that time-driven activity-based costs were significantly higher in patients with FSSs.

Conclusions
Patients with functional somatic syndromes have less favorable PROMs postoperatively, consume more opioids postoperatively, and have higher healthcare costs after elective shoulder and elbow procedures. While PROMs among patients with FSSs are inferior compared to those without FSSs, PROMs still improve compared to baseline.

Paywall, https://www.arthroscopyjournal.org/article/S0749-8063(22)00867-2/fulltext

 

[JemPD]

Well surely it stands to reason that if you are in pain & feeling ill before you go into hospital, you will likely be made worse by a hospital stay & therefore have worse outcomes than those who feel fine on admission. Being on a ward & having surgery would be a nightmare for anyone with ME/CFS, FM, IBS, Headaches, Back pain etc.

And anyone who already has chronic, intrusive, life affecting symptoms is going to be vulnerable and have a worse experience all round. It's ruddy obvious.

Its like saying 'people who already have a problem with nausea/sickness tend to vomit more during long car/train journeys'.

No sh*t Sherlock

 

[rvallee]

Wow, groundbreaking research. Poor people are worse off than rich people after receiving similar fines? Well tell me more mister expert this is legitimately mind-blowing stuff.

Who could have known that people suffering from discriminated health conditions fare worse than people who aren't? What a thoroughly unexpected result.

 

[shak8]

I've read elsewhere, with personal interest that knee replacement surgery on FM people, in a good number of cases, does not relieve pain in the knee (which would be expected) but does restore knee function.

Any surgery is a risk for setting up another pain generating site in FM.