Oosting Ellen, Kapitein Paul J C, de Vries Suzan V, Breedveld Ellen
Department of Orthopedics, Hospital Gelderse Vallei, Willy Brandtlaan, 10 6716 RP, Ede, the Netherlands.
Department of Physiotherapy, Hospital Gelderse Vallei, Ede, the Netherlands.
BMC Musculoskelet Disord. 2021 Apr 16;22(1):361. doi: 10.1186/s12891-021-04240-6.
One of the most important steps before implementing short stay total hip arthroplasty (THA) is establishing patient criteria. Most existing criteria are mainly based on medical condition, but as physical functioning is associated with outcome after THA, we aim to evaluate the added value of a measure of physical functioning to predict short-stay THA.
We used retrospective data of 1559 patients who underwent an anterior THA procedure. Logistic regression analyses were performed to study the predictive value of preoperative variables among which preoperative physical functioning by use of the Timed Up and Go test (TUG) for short stay THA (< 36 h). The receiver operating characteristic (ROC) curve and Youden Index were used to define a cutoff point for TUG associated with short stay THA.
TUG was significantly associated with LOS (OR 0.84, 95%CI 0.82-0.87) as analyzed by univariate regression analysis. In multivariate regression, a model with the TUG had a better performance with an AUC of 0.77 (95%CI 0.74-0.79) and a R of 0.27 compared to the basic model (AUC 0.75, 95%CI 0.73-0.77, R 0.24). Patients with a preoperative TUG less than 9.7 s had an OR of 4.01 (95%CI 3.19-5.05) of being discharged within 36 h.
Performance based physical functioning, measured by the TUG, is associated with short stay THA. This knowledge will help in the decision-making process for the planning and expectations in short stay THA protocols with the advantage that the TUG is a simple and fast instrument to be carried out.
实施短期住院全髋关节置换术（THA）之前最重要的步骤之一是确定患者标准。大多数现有标准主要基于医疗状况，但由于身体功能与THA后的结局相关，我们旨在评估一项身体功能测量指标对预测短期住院THA的附加价值。
我们使用了1559例行前路THA手术患者的回顾性数据。进行逻辑回归分析以研究术前变量的预测价值，其中包括使用计时起立行走测试（TUG）评估的术前身体功能对短期住院THA（<36小时）的预测价值。使用受试者工作特征（ROC）曲线和尤登指数来确定与短期住院THA相关的TUG临界值。
单因素回归分析显示，TUG与住院时间（LOS）显著相关（OR 0.84，95%CI 0.82 - 0.87）。在多因素回归中，与基本模型（AUC 0.75，95%CI 0.73 - 0.77，R 0.24）相比，包含TUG的模型表现更好，AUC为0.77（95%CI 0.74 - 0.79），R为0.27。术前TUG小于9.7秒的患者在36小时内出院的OR为4.01（95%CI 3.19 - 5.05）。
通过TUG测量的基于表现的身体功能与短期住院THA相关。这一知识将有助于短期住院THA方案规划和预期的决策过程，其优势在于TUG是一种简单快捷的测量工具。
