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初次全关节置换术后患者门诊物理治疗利用率较高的相关因素:一项回顾性队列研究

Factors Associated With Higher Utilization of Outpatient Physical Therapy for Patients Who Have Undergone Primary Total Joint Arthroplasty: A Retrospective Cohort Study.

作者信息

Wu Curtis, McAdam Ashleigh, Siverling Scott, Nguyen Joseph, Edwards Danielle

机构信息

Rehabilitation and Performance, Hospital for Special Surgery, New York, NY, USA.

出版信息

HSS J. 2024 Feb;20(1):51-56. doi: 10.1177/15563316231210556. Epub 2023 Nov 14.

Abstract

BACKGROUND

Research has identified predictive factors for inpatient complications and short-term recovery following total knee arthroplasty (TKA) and total hip arthroplasty (THA). Predictors that may influence length of care in outpatient physical therapy (PT) have yet to be examined. Doing so may improve the quality and efficiency of PT care following TKA and THA.

PURPOSE

The aim of this study was to determine factors associated with a higher utilization of outpatient PT visits for patients who have had primary THA or TKA.

METHODS

A retrospective cohort study was performed using a population of 5147 patients who underwent THA and TKA between January 2017 and October 2022. Demographic and clinical factors were analyzed to determine which factors influenced PT utilization.

RESULTS

Our multivariable linear regression model revealed that female sex, need for inpatient PT visits, and TKA as opposed to THA were significantly associated with an increase in outpatient PT visits. Older age, number of telerehabilitation visits, and history of depression were associated with fewer outpatient PT visits while accounting for all other variables.

CONCLUSIONS

The results of this retrospective analysis may help to identify some potential factors including TKA vs THA, patient age, and a history of depression that can be evaluated prospectively in future studies to determine whether they predict subsequent outpatient PT utilization.

摘要

背景

研究已确定全膝关节置换术(TKA)和全髋关节置换术(THA)后住院并发症和短期恢复的预测因素。然而,尚未对可能影响门诊物理治疗(PT)护理时长的预测因素进行研究。这样做可能会提高TKA和THA术后PT护理的质量和效率。

目的

本研究的目的是确定初次接受THA或TKA的患者门诊PT就诊利用率较高的相关因素。

方法

采用回顾性队列研究,研究对象为2017年1月至2022年10月期间接受THA和TKA的5147名患者。分析人口统计学和临床因素,以确定哪些因素会影响PT利用率。

结果

我们的多变量线性回归模型显示,女性、需要住院PT就诊以及接受TKA而非THA与门诊PT就诊次数增加显著相关。在考虑所有其他变量的情况下,年龄较大、远程康复就诊次数以及抑郁病史与门诊PT就诊次数较少相关。

结论

这项回顾性分析的结果可能有助于识别一些潜在因素,包括TKA与THA、患者年龄以及抑郁病史,这些因素可在未来研究中进行前瞻性评估,以确定它们是否能预测随后的门诊PT利用率。

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