Department of Orthopaedic Surgery, University Hospital Carl Gustav Carus, Medical Faculty of the Technical University of Dresden, Germany.
Osteoarthritis Cartilage. 2010 Aug;18(8):1036-42. doi: 10.1016/j.joca.2010.05.003. Epub 2010 Jun 4.
There is limited evidence on social, educational, and occupational factors as predictors of response to total hip replacement (THR). We aimed to analyze these factors in a large population-based setting.
Patients of the Dresden Hip Surgery Registry were recruited and the pre and post (6 months) operative functional status was assessed using the global Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) score (0-100 points). Non-response was defined a gain of <20 points in WOMAC score over a 6 months period and was analyzed with respect to six socioeconomic parameters. Multiple logistic regression modeling was applied to adjust for age, sex, BMI, co-morbidity, and preoperative functional status.
Data from 1007 patients (mean age 61 years, STD 13; 55% women) were included. The average preoperative WOMAC score was 45.8 which increased to 84.4 after surgery. 38.2%, 36.6%, and 25.3% of the patients attended school for 8, 9, and 12 years, respectively. 54.1% were retired, 26.9% worked full time, and 6.7% received a disability pension. A 14.8% of the patients did not achieve a gain of > or =20 points in WOMAC score and were classified as non-responders. After control for confounders, significantly increased risks of non-response were found for widowed patients compared to singles [odds ratio (OR) 4.30, 1.45-12.71], those who lived alone (OR 1.70, 1.02-2.85), and patients with a disability pension compared to those who worked full time (OR 5.81, 2.33-14.46). The risk of non-response decreased with increasing length of school education (12 vs 8 years: OR 0.49, 0.27-0.89). Compared to workers, employees (OR 0.55, 0.33-0.90) and self-employed patients (OR 0.41, 0.18-0.94) showed significantly decreased risks of non-response.
Socioeconomic parameters are independent predictors of response to THR. This can help to improve the health service by identifying subgroups which need special attention in order to increase the response rate.
社会、教育和职业因素作为全髋关节置换（THR）疗效预测因子的相关证据有限。我们旨在人群中对此进行分析。
我们招募了德累斯顿髋关节手术注册中心的患者，并使用全西安大略省和麦克马斯特大学骨关节炎指数（WOMAC）评分（0-100 分）评估术前和术后（6 个月）的功能状态。非应答定义为 WOMAC 评分在 6 个月内增加<20 分，并针对 6 个社会经济参数进行分析。采用多逻辑回归模型调整年龄、性别、BMI、合并症和术前功能状态。
共纳入 1007 例患者（平均年龄 61 岁，标准差 13 岁；55%为女性）。术前 WOMAC 评分为 45.8，术后增至 84.4。分别有 38.2%、36.6%和 25.3%的患者接受了 8、9 和 12 年的学校教育。54.1%的患者退休，26.9%全职工作，6.7%领取残疾抚恤金。14.8%的患者 WOMAC 评分增加未超过 20 分，被归类为无应答者。在控制混杂因素后，与单身相比，丧偶患者的无应答风险显著增加[比值比（OR）4.30，1.45-12.71]，独居者（OR 1.70，1.02-2.85），以及与全职工作者相比，领取残疾抚恤金的患者（OR 5.81，2.33-14.46）。无应答风险随学校教育年限的增加而降低（12 年比 8 年：OR 0.49，0.27-0.89）。与工人相比，员工（OR 0.55，0.33-0.90）和个体经营者（OR 0.41，0.18-0.94）的无应答风险显著降低。
社会经济参数是 THR 疗效的独立预测因子。这有助于通过识别需要特别关注的亚组来改善卫生服务，以提高应答率。
Zotero 插件