Ullmann, Henri Leo Benedikt (2024) The Association of Social Determinants of Health and Patient-Reported Outcomes in Patients with Surgical Treatment of Osteochondral Lesions of the Talus. thesis, Medicine.
Full text available on request.Abstract
Introduction: Osteochondral lesions of the talus (OLT) are defined as lesions involving the cartilaginous and subchondral bony components of the talar dome, commonly arising after chronic ankle sprains and fractures. Surgical intervention is often warranted when symptoms persist, yet the effect Social Determinants of Health (SDOH) have on treatment outcomes is unclear. Methods: This retrospective study analyzed data of OLT patients who underwent operative treatment. Patient-Reported Outcome Measures (PROMs) and Visual Analog Scale (VAS) pain scores were collected, and their trends analyzed regarding patients’ SDOH, including Area Deprivation Index (ADI) and Social Vulnerability Index (SVI). Results: Significant correlations were found between various SDOH and PROMs, elucidating disparities in pain scores, physical function, and depression. A multitude of SVI components, and ADI rank, were found to be significantly correlated to VAS pain scores. Furthermore, insurance status showed a significant impact on pain intensity and depression measures. Discussion: Nuanced influences of race, insurance status, and social vulnerability were observed, suggesting the necessity for a holistic approach to patient care, incorporating screening for social vulnerability into daily clinical practice. Conclusion: This study shows that SDOH have a significant effect on postoperative PROMs and VAS scores. Systemic interventions guided by neighborhood-level measures of disadvantage are key in advancing health equity.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Ashkani-Esfahani, Asst. Prof. Soheil M.D. and Doornberg, Prof. Dr. Job M.D. PhD |
| Faculty: | Medical Sciences |
| Date Deposited: | 28 Jan 2025 13:45 |
| Last Modified: | 28 Jan 2025 13:45 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3796 |
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