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患者报告结局测量信息系统指标能否区分即将接受髋膝关节全关节置换术的患者:一项回顾性病例对照研究

Can Patient-Reported Outcome Measurement Information System Measures Differentiate Patients Who Will Undergo Hip and Knee Total Joint Arthroplasty: A Retrospective Case-Control Study.

作者信息

Horn Maggie E, George Steven Z, Goode Adam P, Reinke Emily K, Scott Lily G, Bolognesi Michael P

机构信息

Department of Orthopaedic Surgery, Duke University, Durham, North Carolina; Department of Population Health Sciences, Duke University, Durham, North Carolina.

Department of Orthopaedic Surgery, Duke University, Durham, North Carolina; Duke Clinical Research Institute, Duke University, Durham, North Carolina.

出版信息

J Arthroplasty. 2022 Jun;37(6S):S56-S62. doi: 10.1016/j.arth.2022.02.053. Epub 2022 Feb 20.

Abstract

BACKGROUND

The Patient-Reported Outcome Measurement Information System (PROMIS) can be used to monitor patients in population-health-based programs. However, it is unknown which measures are most appropriate to differentiate patients who will undergo hip or knee total joint arthroplasty (TJA) in a cohort of patients with osteoarthritis.

METHODS

A retrospective cohort of new patients consulting for treatment from November 17, 2017 to April 20, 2020 (cases: hip: n = 157, knee: n = 112; randomly selected nonsurgical controls: hip: n = 314, knee: n = 224) was extracted from the electronic health record. We recorded demographics, comorbidity, and PROMIS scores for 8 domains (physical function, pain interference, pain intensity, anxiety, depression, sleep disturbance, ability to participate in social roles and activities, and fatigue). We performed descriptive statistics to characterize the cohorts and baseline PROMIS scores and conducted logistic regression models to determine which PROMIS domains differentiated patients undergoing hip and knee TJA.

RESULTS

In univariate comparisons of PROMIS domains, the hip and knee surgical cohorts differed from controls in physical function (P < .01), pain interference (P < .01), and ability to participate in social roles and activities (P < .02). In logistic regression models informed by univariate analyses, PROMIS physical function was the only PROMIS measure to differentiate undergoing surgery in both hip and knee cohorts (P < .01).

CONCLUSION

PROMIS physical function can differentiate TJA cases from nonsurgical controls in both hip and knee patients. These findings have implications for considering which PROMIS measures to administer in patients with hip and knee osteoarthritis.

摘要

背景

患者报告结局测量信息系统(PROMIS)可用于监测基于人群健康的项目中的患者。然而,在骨关节炎患者队列中,尚不清楚哪些测量指标最适合区分即将接受髋或膝关节全关节置换术(TJA)的患者。

方法

从电子健康记录中提取了一个回顾性队列,该队列包括2017年11月17日至2020年4月20日前来咨询治疗的新患者(病例:髋关节:n = 157,膝关节:n = 112;随机选择的非手术对照组:髋关节:n = 314,膝关节:n = 224)。我们记录了人口统计学、合并症以及8个领域的PROMIS评分(身体功能、疼痛干扰、疼痛强度、焦虑、抑郁、睡眠障碍、参与社会角色和活动的能力以及疲劳)。我们进行了描述性统计以描述队列特征和基线PROMIS评分,并进行了逻辑回归模型以确定哪些PROMIS领域能够区分接受髋和膝关节TJA的患者。

结果

在PROMIS领域的单变量比较中,髋关节和膝关节手术队列在身体功能(P <.01)、疼痛干扰(P <.01)以及参与社会角色和活动的能力(P <.02)方面与对照组存在差异。在单变量分析后的逻辑回归模型中,PROMIS身体功能是唯一能够区分髋和膝关节队列中是否接受手术的PROMIS测量指标(P <.01)。

结论

PROMIS身体功能能够区分髋和膝关节患者中的TJA病例与非手术对照组。这些发现对于考虑在髋和膝关节骨关节炎患者中采用哪些PROMIS测量指标具有启示意义。

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