Eneqvist Ted, Nemes Szilárd, Bülow Erik, Mohaddes Maziar, Rolfson Ola
Swedish Hip Arthroplasty Register, Sågbladsgatan 11, 41680, Gothenburg, Sweden.
Department of Orthopaedics, Institute of Clinical Sciences, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Int Orthop. 2018 Feb;42(2):273-279. doi: 10.1007/s00264-017-3711-z. Epub 2018 Jan 3.
We investigated if patient-reported outcomes (PROMs) one year after total hip replacement (THR) can predict the risk of re-operation using data from the Swedish Hip Arthroplasty Register.
A total of 75,899 patients with THR due to osteoarthritis operated in 2002-2014 were included. We used Kaplan-Meier and Cox regression to investigate the relationship between one-year post-operative PROMs and risk of re-operation (all types of further hip surgery). The predictive power of the model and post-operative PROMs were evaluated by concordance index (C).
Kaplan-Meier estimates for not being re-operated at eight years was 95.5% (95%CI; 95.3-95.8). Cox regression analyses showed that all PROMs, except for EQ-VAS, were associated with re-operation. The full model had a concordance index of 0.68. Satisfaction (C = 0.65) and pain (C = 0.65) in isolation had the highest predictive power.
Worse PROMs predicted higher risk of re-operation. Therefore, we believe PROMs may be helpful in identifying patients at risk for re-operation and timely address their problems.
我们利用瑞典髋关节置换登记处的数据，调查全髋关节置换术（THR）一年后的患者报告结局（PROMs）是否能够预测再次手术的风险。
纳入了2002年至2014年因骨关节炎接受THR手术的75899例患者。我们使用Kaplan-Meier法和Cox回归分析来研究术后一年的PROMs与再次手术风险（所有类型的进一步髋关节手术）之间的关系。通过一致性指数（C）评估模型和术后PROMs的预测能力。
八年未再次手术的Kaplan-Meier估计值为95.5%（95%CI：95.3 - 95.8）。Cox回归分析表明，除EQ-VAS外，所有PROMs均与再次手术相关。完整模型的一致性指数为0.68。单独的满意度（C = 0.65）和疼痛（C = 0.65）具有最高的预测能力。
较差的PROMs预示着更高的再次手术风险。因此，我们认为PROMs可能有助于识别有再次手术风险的患者，并及时解决他们的问题。
