Poitras S, Wood K S, Savard J, Dervin G F, Beaule P E
University of Ottawa, Ottawa, Ontario, Canada.
The Ottawa Hospital, Ottawa, Ontario, Canada.
Bone Joint Res. 2015 Sep;4(9):145-51. doi: 10.1302/2046-3758.49.2000417.
Patient function after arthroplasty should ideally quickly improve. It is not known which peri-operative function assessments predict length of stay (LOS) and short-term functional recovery. The objective of this study was to identify peri-operative functions assessments predictive of hospital LOS and short-term function after hospital discharge in hip or knee arthroplasty patients.
In total, 108 patients were assessed peri-operatively with the timed-up-and-go (TUG), Iowa level of assistance scale, post-operative quality of recovery scale, readiness for hospital discharge scale, and the Western Ontario and McMaster Osteoarthritis Index (WOMAC). The older Americans resources and services activities of daily living (ADL) questionnaire (OARS) was used to assess function two weeks after discharge.
Following multiple regressions, the pre- and post-operative day two TUG was significantly associated with LOS and OARS score, while the pre-operative WOMAC function subscale was associated with the OARS score. Pre-operatively, a cut-off TUG time of 11.7 seconds for LOS and 10.3 seconds for short-term recovery yielded the highest sensitivity and specificity, while a cut-off WOMAC function score of 48.5/100 yielded the highest sensitivity and specificity. Post-operatively, a cut-off day two TUG time of 31.5 seconds for LOS and 30.9 seconds for short-term function yielded the highest sensitivity and specificity.
The pre- and post-operative day two TUG can indicate hospital LOS and short-term functional capacities, while the pre-operative WOMAC function subscale can indicate short-term functional capacities. Cite this article: Bone Joint Res 2015;4:145-151.
关节置换术后患者功能理想情况下应迅速改善。目前尚不清楚哪些围手术期功能评估可预测住院时间(LOS)和短期功能恢复情况。本研究的目的是确定可预测髋或膝关节置换术患者住院LOS及出院后短期功能的围手术期功能评估指标。
总共对108例患者进行围手术期评估,采用计时起立行走测试(TUG)、爱荷华州协助水平量表、术后恢复质量量表、出院准备量表以及西安大略和麦克马斯特大学骨关节炎指数(WOMAC)。使用美国老年人资源与服务日常生活活动(ADL)问卷(OARS)评估出院两周后的功能。
经过多元回归分析,术前及术后第二天的TUG与住院LOS及OARS评分显著相关,而术前WOMAC功能子量表与OARS评分相关。术前,预测住院LOS的TUG时间截断值为11.7秒,预测短期恢复的截断值为10.3秒时,敏感性和特异性最高;而WOMAC功能评分截断值为48.5/100时,敏感性和特异性最高。术后,预测住院LOS的术后第二天TUG时间截断值为31.5秒,预测短期功能的截断值为30.9秒时,敏感性和特异性最高。
术前及术后第二天的TUG可提示住院LOS及短期功能能力,而术前WOMAC功能子量表可提示短期功能能力。引用本文:Bone Joint Res 2015;4:145 - 151。