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老年患者全膝关节置换术前期望分析。

Analysis of the expectations of elderly patients before undergoing total knee replacement.

机构信息

Physical Medicine and Rehabilitation, Hospitals Mar-Esperança, Institut Municipal d'Assistència Sanitària, Sant Josep de la Muntanya, 12, 08024 Barcelona, Spain.

出版信息

Arch Gerontol Geriatr. 2010 Nov-Dec;51(3):e83-7. doi: 10.1016/j.archger.2010.01.003. Epub 2010 Jan 29.

DOI:10.1016/j.archger.2010.01.003
PMID:20116111
Abstract

The opinion of patients expressed in terms of satisfaction is extremely important in any evaluation of total knee arthroplasty (TKA) results. The primary endpoint of this study was to determine the quantitative and qualitative expectations of elderly patients before undergoing TKA. Cross-sectional study of 497 patients over 65 years was performed before TKA. Main variables collected: demographic, functioning, pain, comorbidity, depression and expectations assessed with the Hospital for Special Knee Replacement Expectation Survey. Statistical tests used were: Student's t-test, analysis of variance, Spearman's ρ and multivariate regression analysis. The means of the total and maximum expectations were 12.3±1.63 and 9.5±1.78 (±S.D.), respectively. Between 90 and 100% of patients referred expectations to improvement regarding pain, basic functional activities (walking, climbing stairs, knee mobility, general mobility) and general well being. There were statistically significant correlations with age (r=-0.321), pain before operation (r=-0.206), expected pain at 6 months (r=-0.206), depressive symptoms (r=-0.180) and the Barthel index (BI) (r=0.154). One can conclude, that the expectations of improvement among patients before TKA are high and may be classified as expectations of improvement of pain, basic functional activities and general well being. Age, pain intensity and presence of depression correlate inversely with the amount of expectations.

摘要

患者满意度是评估全膝关节置换术(TKA)结果的重要指标。本研究的主要终点是确定老年患者在接受 TKA 前的定量和定性期望。在 TKA 前对 497 名 65 岁以上的患者进行了横断面研究。主要收集的变量包括人口统计学、功能、疼痛、合并症、抑郁和使用特殊膝关节置换期望调查(Hospital for Special Knee Replacement Expectation Survey)进行评估的期望。使用的统计检验包括:学生 t 检验、方差分析、斯皮尔曼 ρ 和多变量回归分析。总期望和最大期望的平均值分别为 12.3±1.63 和 9.5±1.78(±S.D.)。90%至 100%的患者表示期望在疼痛、基本功能活动(行走、上下楼梯、膝关节活动度、整体活动度)和整体健康状况方面有所改善。年龄(r=-0.321)、术前疼痛(r=-0.206)、6 个月预期疼痛(r=-0.206)、抑郁症状(r=-0.180)和巴氏指数(BI)(r=0.154)与期望之间存在显著相关性。可以得出结论,TKA 前患者对改善的期望较高,可以将其归类为疼痛、基本功能活动和整体健康状况改善的期望。年龄、疼痛强度和抑郁的存在与期望的数量呈负相关。

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