Lieberman J R, Dorey F, Shekelle P, Schumacher L, Kilgus D J, Thomas B J, Finerman G A
Department of Orthopaedic Surgery, University of California at Los Angeles Medical Center 90095, USA.
J Arthroplasty. 1997 Sep;12(6):639-45. doi: 10.1016/s0883-5403(97)90136-4.
The purpose of this study was to examine the relationship between the Harris Hip Score (HHS), a traditional method of patient assessment of a total hip arthroplasty (THA), and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), a commonly used health-related quality-of-life survey. One hundred forty patients returning for routine clinical follow-up evaluation of a primary THA were asked to fill out the SF-36 quality-of-life survey, as well as questions concerning their perceptions of their THA. The patient's surgeon assessed the THA with the traditional HHS. The correlations between the HHS and the SF-36 domains were highest in the physical component summary scores for male patients of all ages and female patients 65 years of age or older. The correlations were lower for the mental component summary scores of all patients, but particularly in female patients younger than 65. When the SF-36 scores were compared with age and sex-matched population norms, both age and sex were found to be important. Men younger than 65 had scores lower than norms in the physical function domains, but were comparable in the mental health domains. The older men had scores comparable to the norms in all domains. Female patients of all ages, however, had lower scores in the physical function domains. The greatest differences were noted in the female patients younger than 65. The HHS is commonly used to assess disease-specific pain and function in THA patients; however, the results of this study suggest that the SF-36 health survey can capture additional important quality-of-life domains that are influenced by a THA and that these domains are influenced by the age and sex of the patient. The combination of a disease-specific scoring system and a quality-of-life survey would allow a more global assessment of a THA in all patients. Studies evaluating the results of THAs should either assess the results of male and female patients separately when sample size is sufficiently large or use sex as a possible covariate in a multivariate analysis.
本研究的目的是探讨全髋关节置换术（THA）患者评估的传统方法——Harris髋关节评分（HHS）与常用的健康相关生活质量调查问卷——医学结局研究简明健康调查问卷（SF - 36）之间的关系。140例接受初次全髋关节置换术并前来进行常规临床随访评估的患者被要求填写SF - 36生活质量调查问卷，以及关于他们对全髋关节置换术看法的问题。患者的外科医生用传统的HHS对全髋关节置换术进行评估。HHS与SF - 36各领域之间的相关性在所有年龄段的男性患者以及65岁及以上女性患者的身体成分汇总得分中最高。所有患者的心理成分汇总得分之间的相关性较低，尤其是65岁以下的女性患者。当将SF - 36得分与年龄和性别匹配的人群常模进行比较时，发现年龄和性别都很重要。65岁以下的男性在身体功能领域的得分低于常模，但在心理健康领域的得分相当。年龄较大的男性在所有领域的得分与常模相当。然而，所有年龄段的女性患者在身体功能领域的得分较低。65岁以下的女性患者差异最为明显。HHS通常用于评估全髋关节置换术患者特定疾病的疼痛和功能；然而，本研究结果表明，SF - 36健康调查可以捕捉到受全髋关节置换术影响的其他重要生活质量领域，并且这些领域受患者年龄和性别的影响。特定疾病评分系统与生活质量调查相结合，将能够对所有患者的全髋关节置换术进行更全面的评估。评估全髋关节置换术结果的研究，在样本量足够大时应分别评估男性和女性患者的结果，或者在多变量分析中使用性别作为可能的协变量。
