Ross Lauren A, O'Rourke Sara C, Toland Gemma, MacDonald Deborah J, Clement Nick D, Scott Chloe E H
Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK.
Department of Orthopaedics, University of Edinburgh, Edinburgh, UK.
Bone Jt Open. 2022 Apr;3(4):275-283. doi: 10.1302/2633-1462.34.BJO-2022-0013.R1.
The aim of this study was to determine satisfaction rates after hip and knee arthroplasty in patients who did not respond to postoperative patient-reported outcome measures (PROMs), characteristics of non-responders, and contact preferences to maximize response rates.
A prospective cohort study of patients planned to undergo hip arthroplasty (n = 713) and knee arthroplasty (n = 737) at a UK university teaching hospital who had completed preoperative PROMs questionnaires, including the EuroQol five-dimension health-related quality of life score, and Oxford Hip Score (OHS) and Oxford Knee Score (OKS). Follow-up questionnaires were sent by post at one year, including satisfaction scoring. Attempts were made to contact patients who did not initially respond. Univariate, logistic regression, and receiver operator curve analysis was performed.
At one year, 667 hip patients (93.5%) and 685 knee patients (92.9%) had undergone surgery and were alive. No response was received from 151/667 hip patients (22.6%), 83 (55.0%) of whom were ultimately contacted); or from 108/685 knee patients (15.8%), 91 (84.3%) of whom were ultimately contacted. There was no difference in satisfaction after arthroplasty between initial non-responders and responders for hips (74/81 satisfied vs 476/516 satisfied; p = 0.847) or knees (81/93 satisfied vs 470/561 satisfied; p = 0.480). Initial non-response and persistent non-response was associated with younger age, higher BMIs, and worse preoperative PROMs for both hip and knee patients (p < 0.050). Being in employment was associated with persistent non-response for hip patients (p = 0.047). Multivariate analysis demonstrated that younger age (p < 0.038), higher BMI (p = 0.018), and poorer preoperative OHS (p = 0.031) were independently associated with persistent non-response to hip PROMs. No independent associations were identified for knees. Using a threshold of > 66.4 years predicted a preference for contact by post (area under the curve 0.723 (95% confidence interval (CI) 0.647 to 0.799; p < 0.001, though this CI crosses the 0.7 limit considered reliable).
The majority of initial non-responders were ultimately contactable with effort. Satisfaction rates were not inferior in patients who did not initially respond to PROMs. Cite this article: 2022;3(4):275-283.
本研究旨在确定对术后患者报告结局测量（PROMs）无反应的患者在髋关节和膝关节置换术后的满意度、无反应者的特征以及能使反应率最大化的联系偏好。
对英国一家大学教学医院计划接受髋关节置换术（n = 713）和膝关节置换术（n = 737）的患者进行前瞻性队列研究，这些患者已完成术前PROMs问卷，包括欧洲五维健康相关生活质量评分、牛津髋关节评分（OHS）和牛津膝关节评分（OKS）。随访问卷在术后一年通过邮寄方式发送，包括满意度评分。尝试联系最初未回复的患者。进行了单因素、逻辑回归和受试者工作特征曲线分析。
一年时，667例髋关节患者（93.5%）和685例膝关节患者（92.9%）已接受手术且存活。151/667例髋关节患者未回复（22.6%），其中83例（55.0%）最终被联系上；108/685例膝关节患者未回复（15.8%），其中91例（84.3%）最终被联系上。髋关节置换术后，最初无反应者和有反应者之间的满意度无差异（74/81例满意 vs 476/516例满意；p = 0.847），膝关节置换术后也无差异（81/93例满意 vs 470/561例满意；p = 0.480）。髋关节和膝关节患者最初无反应和持续无反应与年龄较小、体重指数较高以及术前PROMs较差有关（p < 0.050）。就业与髋关节患者持续无反应有关（p = 0.047）。多因素分析表明，年龄较小（p < 0.038）、体重指数较高（p = 0.018）和术前OHS较差（p = 0.031）与髋关节PROMs持续无反应独立相关。未发现膝关节有独立关联。使用> 66.4岁的阈值预测更倾向于通过邮寄方式联系（曲线下面积0.723（95%置信区间（CI）0.647至0.799；p < 0.001，尽管此CI跨越了被认为可靠的0.7界限）。
大多数最初无反应者最终经过努力是可以联系上的。最初对PROMs无反应的患者满意度并不低。引用本文：2022；3(4):275 - 283。
