Quantifying the Impact of Postoperative Complications Using PROMIS-Global Physical Health Scores in Orthopaedic Trauma Patients

OBJECTIVES: This study aimed to (1) correlate orthopaedic trauma postoperative complications and PROMIS-GPH scores and (2) quantify the impact of complications on reduction of scores. DESIGN: Retrospective cohort study. SETTING: Multicenter of 3 institutions. PATIENT SELECTION CRITERIA: Included were all orthopaedic trauma patients with operative injuries from 2018 to 2024 who completed at least 1 postoperative PROMIS-Global Physical Health (PROMIS-GPH) survey at 6 weeks, 3 months, 6 months, or 1 year. OUTCOME MEASURES AND COMPARISONS: Primary study outcome was the development of major or minor complications. Major complications were defined as any fracture-related reoperation within 1 year or fracture-related readmission within 90 days. Minor complications were defined as symptomatic hardware removal within 1 year or 90-day readmission or emergency department visit. Average PROMIS-GPH scores at each timepoint was compared between patients with major or minor complications and no complications. RESULTS: A total of 3475 orthopaedic trauma patients with operative injuries who completed at least 1 postoperative PROMIS-GPH survey were included. Female patients were 62.1% of the cohort. Average age of the entire cohort was 58.4 (range 18-103). The most common fracture subtypes were ankle injuries (21.9%) and hip injuries (21.8%). Of all patients, 9.2% had major complications and 13.6% minor complications. Of patients with no complications, 29.3% were in the lowest PROMIS-GPH quartile at some timepoint compared with 36.1% with minor complications and 43.6% with major complications (P < 0.0001). Being in the lowest quartile of PROMIS-GPH scores was a significant predictor of major complications (aOR 1.5, 95% confidence interval: 1.2-2.0, P = 0.002). At all timepoints, patients with no complications had significantly higher scores than patients with major or minor complications, by at least an average 1.5 points. CONCLUSIONS: Significant associations between postoperative major or minor complications and poor PROMIS-GPH scores existed in orthopaedic trauma patients presenting for operative management. LEVEL OF EVIDENCE: Level III, Retrospective Cohort Study. See Instructions for Authors for a complete description of levels of evidence.