Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK.
Department of Orthopaedics, University of Edinburgh, Edinburgh, UK.
Bone Joint J. 2021 Apr;103-B(4):672-680. doi: 10.1302/0301-620X.103B.BJJ-2021-0104.R1. Epub 2021 Mar 23.
The aim of this study was to assess the quality of life of patients on the waiting list for a total hip (THA) or knee arthroplasty (KA) during the COVID-19 pandemic. Secondary aims were to assess whether length of time on the waiting list influenced quality of life and rate of deferral of surgery.
During the study period (August and September 2020) 843 patients (THA n = 394, KA n = 449) from ten centres in the UK reported their EuroQol five dimension (EQ-5D) scores and completed a waiting list questionnaire (2020 group). Patient demographic details, procedure, and date when listed were recorded. Patients scoring less than zero for their EQ-5D score were defined to be in a health state "worse than death" (WTD). Data from a retrospective cohort (January 2014 to September 2017) were used as the control group.
The 2020 group had a significantly worse EQ-5D score compared to the control group for both THA (p < 0.001) and KA (p < 0.001). Over one-third (35.0%, n = 138/394) of patients waiting for a THA and nearly a quarter (22.3%, n = 100/449) for KA were in a health state WTD, which was significantly greater than the control group (odds ratio 2.30 (95% confidence interval (CI) 1.83 to 2.93) and 2.08 (95% CI 1.61 to 2.70), respectively; p < 0.001). Over 80% (n = 680/843) of the 2020 group felt that their quality of life had deteriorated while waiting. Each additional month spent on the waiting list was independently associated with a decrease in quality of life (EQ-5D: -0.0135, p = 0.004). There were 117 (13.9%) patients who wished to defer their surgery and the main reason for this was health concerns for themselves and or their family (99.1%, n = 116/117).
Over one-third of patients waiting for THA and nearly one-quarter waiting for a KA were in a state WTD, which was approaching double that observed prior to the pandemic. Increasing length of time on the waiting list was associated with decreasing quality of life. Level of evidence: Level III retrospective case control study Cite this article: 2021;103-B(4):672-680.
本研究旨在评估 COVID-19 大流行期间等待全髋关节置换术（THA）或膝关节置换术（KA）的患者的生活质量。次要目的是评估等待名单上的时间长短是否会影响生活质量和手术推迟的比例。
在研究期间（2020 年 8 月至 9 月），英国 10 个中心的 843 名患者（THA 组 394 名，KA 组 449 名）报告了他们的 EuroQol 五维（EQ-5D）评分，并完成了等待名单问卷（2020 组）。记录患者的人口统计学细节、手术类型和列入名单的日期。EQ-5D 评分低于零的患者被定义为处于“比死亡更差”（WTD）的健康状态。使用 2014 年 1 月至 2017 年 9 月的回顾性队列数据作为对照组。
2020 组的 THA（p < 0.001）和 KA（p < 0.001）的 EQ-5D 评分均明显低于对照组。超过三分之一（35.0%，n = 138/394）等待 THA 的患者和近四分之一（22.3%，n = 100/449）等待 KA 的患者处于 WTD 状态，明显高于对照组（比值比 2.30（95%置信区间（CI）1.83 至 2.93）和 2.08（95% CI 1.61 至 2.70）；p < 0.001）。2020 组中超过 80%（n = 680/843）的患者表示，他们在等待期间的生活质量恶化。在等待名单上每多待一个月，生活质量（EQ-5D）就会独立下降（-0.0135，p = 0.004）。有 117 名（13.9%）患者希望推迟手术，主要原因是他们自己和/或家人的健康问题（99.1%，n = 116/117）。
超过三分之一等待 THA 的患者和近四分之一等待 KA 的患者处于 WTD 状态，接近大流行前的两倍。在等待名单上的时间长短与生活质量的下降有关。
三级回顾性病例对照研究
2021;103-B（4）：672-680.
