骨关节炎患者中更高的无助感预示着关节置换手术的结果。
Greater perceived helplessness in osteoarthritis predicts outcome of joint replacement surgery.
作者信息
Gandhi Rajiv, Razak Fahad, Tso Peggy, Davey J Roderick, Mahomed Nizar N
机构信息
Division of Orthopedic Surgery, University of Toronto, Toronto, Ontario, Canada.
出版信息
J Rheumatol. 2009 Jul;36(7):1507-11. doi: 10.3899/jrheum.080466. Epub 2009 Jun 1.
OBJECTIVE
To determine if there is a difference between male and female patients in their perceived control of osteoarthritis (OA) symptoms at the time of joint replacement surgery, as measured by the Arthritis Helplessness Index (AHI), and how this helplessness affects surgical outcomes at 1 year.
METHODS
From a joint replacement registry, 70 male and 70 female patients were randomly selected and matched for age, body mass index, comorbidity, procedure, and education. Patients completed the AHI prior to surgery. Functional status was assessed at baseline and 1-year followup with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. Linear regression modeling was used to determine the effect of sex on predicting AHI scores. A second model was constructed to examine the effect of AHI on the 1-year WOMAC change score.
RESULTS
There were no statistically significant differences in demographic data or clinically significant differences in AHI scores between sexes. Linear regression modeling showed that female sex was a significant predictor of a greater AHI score prior to surgery (p < 0.05). Moreover, a greater AHI score was an independent predictor of a lower WOMAC change score at 1 year (p = 0.01).
CONCLUSION
Interventions to improve control over arthritis symptoms should be studied with the goal of improving surgical outcomes.
目的
通过关节炎无助感指数(AHI)来确定在关节置换手术时,男性和女性患者在对骨关节炎(OA)症状的感知控制方面是否存在差异,以及这种无助感如何影响1年时的手术结果。
方法
从关节置换登记处随机选取70例男性和70例女性患者,并在年龄、体重指数、合并症、手术方式和教育程度方面进行匹配。患者在手术前完成AHI评估。使用西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分在基线和1年随访时评估功能状态。采用线性回归模型确定性别对预测AHI评分的影响。构建第二个模型以检验AHI对1年WOMAC变化评分的影响。
结果
男女之间在人口统计学数据上无统计学显著差异,AHI评分也无临床显著差异。线性回归模型显示,女性是术前AHI评分较高的显著预测因素(p < 0.05)。此外,较高的AHI评分是1年时WOMAC变化评分较低的独立预测因素(p = 0.01)。
结论
应以改善手术结果为目标,研究改善对关节炎症状控制的干预措施。