Decision for reconstructive interventions of the upper extremities in tetraplegia: the effect of treatment characteristics.

Objective:

To assess the effect of treatment characteristics on the decisions made by subjects with tetraplegia concerning reconstructive interventions for the upper extremities.




Design:

Survey.




Setting:

Seven specialized spinal cord injury centres in the Netherlands.




Patients:

A sample of 49 individuals with tetraplegia in a stable condition.




Interventions:

Not applicable.




Main outcome measure:

Importance and the relative weight of 7 treatment characteristics on the decision to undergo reconstructive surgery determined by means of Conjoint Analysis.




Results:

All 7 characteristics contributed to the decision to undergo surgery (p< 0.01). The relative weights were: for type of intervention 0.14 (95% confidence interval (CI) 0.05-0.23), for number of operations 0.15 (95% CI: 0.05-0.25), for inpatient rehabilitation period 0.22 (95% CI: 0.10-0.32), for outpatient rehabilitation period 0.08 (95% CI: 0.02-0.14), for risk of complications 0.16 (95% CI:0.06-0.26), for results of elbow function 0.1 (95% CI:0.02-0.18), and for results of hand function 0.15 (95% CI: 0.05-0.25). In 40.8% of the subjects one characteristic had a relative weight of 0.30 or more.




Conclusions:

Non-health outcome factors related to the intensity of treatment are as important or even or more important than the potential outcome of hand or elbow function in the decision to undergo reconstructive therapy. Inpatient rehabilitation period was the most important factor, and a substantial number of subjects focus on only one characteristic in their decision-making process.

None; study was a survey.

N/A

None.