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髋关节和膝关节置换术后患者从初次就诊到手术当天的患者报告结局测量评分变化。

Changes in Patient Reported Outcome Measure Scores From Initial Presentation to Day-of-Surgery in Patients Undergoing Hip and Knee Arthroplasty.

机构信息

Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan.

出版信息

J Arthroplasty. 2022 Dec;37(12):2340-2346. doi: 10.1016/j.arth.2022.05.046. Epub 2022 Jun 5.

Abstract

BACKGROUND

It is not well understood how patient reported outcome measures (PROMs) change from initial presentation to day-of-surgery (DOS). This study sought to quantify preoperative PROM changes for hip and knee arthroplasty patients.

METHODS

A retrospective review was performed on primary total hip, total knee, and partial knee arthroplasty patients from October 2020 through January 2021. Trends in preoperative Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF), Hip Disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS-JR), and Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR) scores were compared using scores at initial presentation in the ambulatory clinic and at a time near the date-of-surgery. A total of 497 patients possessed 2 preoperative PROMIS-PF (497/497), HOOS-JR (152/497), or KOOS-JR (258/497) surveys.

RESULTS

There was no significant statistical difference in mean PROM scores between initial presentation and DOS PROMIS-PF or HOOS-JR scores. Only KOOS-JR demonstrated a significant statistical difference of 2 ± 14 (P = .002) when comparing initial versus preoperative scores. Partial knee arthroplasty patients saw a strong positive correlation (r = 0.77) between initial PROMIS-PF and DOS scores. However, mean absolute value changes on an individual level were 4 ± 4, 11 ± 39, and 11 ± 10 for PROMIS-PF, HOOS-JR, and KOOS-JR, respectively, indicating the presence of meaningful patient-level score changes as based on previously published anchor-based minimal clinically important differences.

CONCLUSION

PROMs collected during the preoperative period demonstrated wide variability at an individual level, but not at a population level. Collection at both time points may be necessary in order to understand the clinical impact of surgery on these patients.

摘要

背景

患者报告的结局测量(PROM)从初始表现到手术日(DOS)的变化尚不清楚。本研究旨在量化髋膝关节置换患者的术前 PROM 变化。

方法

对 2020 年 10 月至 2021 年 1 月期间的初次全髋关节置换、全膝关节置换和部分膝关节置换患者进行回顾性分析。使用门诊初始就诊和接近手术日期时的患者报告的结局测量信息系统(PROMIS)物理功能(PROMIS-PF)、髋关节残疾和骨关节炎结果评分(HOOS-JR)和膝关节损伤和骨关节炎结果评分(KOOS-JR)评分,比较术前 PROMIS-PF(497/497)、HOOS-JR(152/497)或 KOOS-JR(258/497)评分的趋势。共有 497 例患者具有 2 项术前 PROMIS-PF、HOOS-JR 或 KOOS-JR 调查结果。

结果

初始就诊和 DOS PROMIS-PF 或 HOOS-JR 评分之间的平均 PROM 评分无统计学差异。仅 KOOS-JR 比较初始与术前评分时存在统计学差异(2±14,P=0.002)。部分膝关节置换患者初始 PROMIS-PF 与 DOS 评分之间存在强正相关(r=0.77)。然而,个体水平的平均绝对值变化分别为 4±4、11±39 和 11±10,用于 PROMIS-PF、HOOS-JR 和 KOOS-JR,表明基于先前发表的基于锚定的最小临床重要差异,存在有意义的患者水平评分变化。

结论

术前期间收集的 PROM 在个体水平上表现出很大的变异性,但在人群水平上没有。为了了解手术对这些患者的临床影响,可能需要同时采集这两个时间点的数据。

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