Hoelen Thomay-Claire A, Heijnens Luc J M, Jelsma Jetse, van Steenbergen Liza N, Schotanus Martijn G M, Boonen Bert, Most Jasper
Department Orthopedics, Zuyderland Medical Center, Sittard-Geleen, The Netherlands; Department Orthopedics, School of Care and Public Health Research Institute, Faculty of Health, Medicine and Life Science, Maastricht University Medical Center, Maastricht, The Netherlands.
Department Orthopedics, Zuyderland Medical Center, Sittard-Geleen, The Netherlands.
J Arthroplasty. 2024 Sep;39(9):2173-2178.e2. doi: 10.1016/j.arth.2024.04.013. Epub 2024 Apr 13.
To determine the association between socioeconomic status (SES) and patient-reported outcome measures in a Dutch cohort who have undergone total hip arthroplasty (THA) or total knee arthroplasty (TKA).
A retrospective national registry study of all patients who underwent primary THA or TKA between 2014 and 2020 in the Netherlands was performed. Linear mixed effects regression models were used to assess the association between SES and patient-reported outcome measures for THA and TKA patients separately. The following measures were collected: numeric rating scale for pain, Oxford Hip/Knee Score, Hip/Knee disability and Osteoarthritis Outcome Score, and the EuroQol 5-Dimensions questionnaire. Sex, age, body mass index, American Society of Anesthesiologists classification, Charnley classification, and smoking status were considered as covariates in the models.
THA patients (n = 97,443) were on average 70 years old with a body mass index of 27.4 kg/m, and TKA patients (n = 78,811) were on average 69 years old with a body mass index of 29.7 kg/m. Preoperatively, patients with a lower SES undergoing THA or TKA reported more severe symptoms and lower health-related quality of life. At 1-year follow-up, they also reported lower scores and less improvement over time compared to patients with a higher SES.
Patients with lower SES report worse symptoms when admitted for surgery and less improvement after surgery. Future research must address potentially mediating factors of the association between SES and symptom reporting such as access to surgery and rehabilitation, subjectivity in reporting, and patient expectation for THA and TKA outcomes.
确定在荷兰接受全髋关节置换术（THA）或全膝关节置换术（TKA）的队列中社会经济地位（SES）与患者报告的结局指标之间的关联。
对2014年至2020年期间在荷兰接受初次THA或TKA的所有患者进行了一项回顾性全国登记研究。分别使用线性混合效应回归模型评估THA和TKA患者的SES与患者报告的结局指标之间的关联。收集了以下指标：疼痛数字评定量表、牛津髋关节/膝关节评分、髋关节/膝关节残疾和骨关节炎结局评分以及欧洲五维健康量表问卷。性别、年龄、体重指数、美国麻醉医师协会分级、查尔尼分级和吸烟状况在模型中被视为协变量。
THA患者（n = 97,443）平均年龄70岁，体重指数为27.4 kg/m²，TKA患者（n = 78,811）平均年龄69岁，体重指数为29.7 kg/m²。术前，接受THA或TKA的SES较低的患者报告有更严重的症状和较低的健康相关生活质量。在1年随访时，与SES较高的患者相比，他们报告的分数也较低，且随时间改善较少。
SES较低的患者在入院手术时报告的症状更差，术后改善也较少。未来的研究必须解决SES与症状报告之间关联的潜在中介因素，如手术和康复的可及性、报告的主观性以及患者对THA和TKA结局的期望。
