JOT - 2026-04-10 - Journal Article
Higher Baseline Resiliency Scores Correlate With Better Patient-Reported Outcomes Following Acetabular Fixation.
McIlwain RN, Litten RM, McConnell MJ, Bhatti HS, Ellis JD, Johnson JP, Spitler CA
Topics
Key Takeaway
High baseline resilience (BRS ≥3.7) independently predicted 12.4-point better PROMIS Global Mental Health and 6.7-point better Physical Function at 6 months following operative acetabular fracture fixation.
Summary Depth
Choose how much analysis to show on this article page.
Summary
This study asked whether Brief Resilience Scale scores obtained 2 weeks postoperatively predict PROMIS outcomes at 6 and 12 months after operative acetabular fracture fixation in 111 adults at a single Level I center. High-resilience patients (BRS ≥3.7) demonstrated independently better PROMIS Physical Function (β=6.73), Global Physical Health (β=8.88), and Global Mental Health (β=12.40) and lower Pain Interference (β=-7.83), Depression (β=-15.33), and Anxiety (β=-11.54) at 6 months on multivariable regression. Associations across all PROMIS domains remained significant at 12 months.
Key Limitation
The 49% attrition rate at 12 months (111 enrolled to 56 completing) introduces substantial selection bias, as patients lost to follow-up may systematically differ in resilience or outcomes.
Original Abstract
OBJECTIVES
To determine if patient resiliency is associated with patient-reported outcomes at six and twelve months following surgical fixation of acetabular fractures.
METHODS
Design: Retrospective cohort study.
SETTING
Single Level I trauma center (2022-2024).
PATIENT SELECTION CRITERIA
Adults who sustained an acetabulum fracture (AO/OTA 62) treated operatively and completed Brief Resilience Scale (BRS) surveys two-weeks postoperatively and Patient-Reported Outcomes Measurement Information System (PROMIS) surveys at six- and/or twelve-months postoperatively were included.
OUTCOME MEASURES AND COMPARISONS
Primary outcomes were scores for PROMIS Physical Function (PF), Global Physical Health (GPH), Global Mental Health (GMH), Pain Interference (PI), Depression, Anxiety, and Brief Resilience Scale (BRS). PROMIS scores were compared between low and high resiliency individuals at six- and twelve-months, as defined by the cohort median BRS score. Multivariable linear regression was used to adjust for relevant clinical covariates.
RESULTS
A total of 111 patients were included; 81 patients (64.2% male, 60.5% white; mean age 51.1 years) completed 6-month surveys and 56 patients (75.0% male, 66.1% white; mean age 51.8 years) completed 12-month surveys. At six months, high resiliency (BRS (≥ 3.7) was independently associated with higher PROMIS PF (β = 6.73 [2.93-10.54], p < 0.001), GPH ((β = 8.88 [5.47-12.28], p < 0.001), and GMH ((β = 12.40 [8.48-16.32], p < 0.001) with lower PI ((β = -7.83 [-11.25 to -4.40], p < 0.001), Depression ((β = -15.33 [-19.69 to -10.97], p < 0.001), and Anxiety ((β = -11.54 [-16.35 to -6.72], p < 0.001) scores on regression analysis. Similarly, highly resilient (BRS ≥ 3.6) individuals completing 12-month surveys had significantly positive associations across all domains.
CONCLUSIONS
Compared to patients with low resilience, high baseline resilience was associated with significantly better PROMIS outcomes at six and twelve months following acetabular fixation.
LEVEL OF EVIDENCE
III.