Do Patient Expectations Influence Patient-Reported Outcomes and Satisfaction in Total Hip Arthroplasty? A Prospective, Multicenter Study
Do Patient Expectations Influence Patient-Reported Outcomes and Satisfaction in Total Hip Arthroplasty? A Prospective, Multicenter Study
复制标题
DOI：
10.1016/j.arth.2017.06.017
复制
发表时间：
2017-11-01
影响因子：
3.5
通讯作者：
Bozic, Kevin J.
中科院分区：
文献类型：
--
作者：
Jain, Deeptee;Bendich, Ilya;Bozic, Kevin J.
背景：全髋关节置换术（THA）患者的患者期望与患者报告结果（PRO）之间的关系存在争议。本研究的目的是探讨术前患者期望对术后 PRO 和患者满意度的影响。方法：这是一项针对初次 THA 患者的前瞻性多中心观察性队列研究。术前，患者完成特殊外科医院 (HSS) 髋关节置换期望调查（期望）、12 项简短调查 (SF-12)、加州大学洛杉矶分校 (UCLA) 活动评分以及髋关节残疾和骨关节炎评分 (HOOS)。术后6个月和1年，患者完成了特殊外科髋关节置换医院期望调查（fulfillment of Expectations）、满意度调查，PROs与术前相同。创建逐步多元回归模型。结果：共有 207 名患者入组。 6 个月随访率为 91%，1 年随访率为 92%。就业和较低的 HOOS 基线预示着更高的期望（就业状况：B = -7.5，P = .002；HOOS：B = -0.27，P = .002）。较高的术前期望预示 6 个月时 UCLA 活动、SF-12 身体成分评分和 HOOS（UCLA 活动：B = 0.03，P = .001；SF-12 身体成分评分：B = 0.15，P = .001；HOOS：B = 0.20；P = .008）和 1 年时 UCLA 活动（B = 0.02，P = .008）有更大改善。 .004）。此外，更高的期望预示着更高的术后满意度和 6 个月时期望的实现（满意度：B = 0.21，P < .001；期望的实现：B = 0.30，P
Background: The relationship between patient expectations and patient-reported outcomes (PROs) in total hip arthroplasty (THA) patients is controversial. The purpose of this study was to examine the impact of preoperative patient expectations on postoperative PROs and patient satisfaction.Methods: This was a prospective multicenter observational cohort study of primary THA patients. Preoperatively, patients completed Hospital for Special Surgery (HSS) Hip Replacement Expectations Survey (expectations), 12 item Short Form Survey (SF-12), University of California, Los Angeles (UCLA) activity score, and Hip Disability and Osteoarthritis Score (HOOS). Postoperatively at 6 months and 1 year, patients completed the Hospital for Special Surgery Hip Replacement Fulfillment of Expectations Survey (fulfillment of expectations), a satisfaction survey, and the same PROs as preoperatively. Stepwise multivariate regression models were created.Results: A total of 207 patients were enrolled. Follow-up rate was 91% at 6 months and 92% at 1 year. Being employed and lower baseline HOOS predicted higher expectations (employment status: B = -7.5, P = .002; HOOS: B = -0.27, P = .002). Higher preoperative expectations predicted greater improvements in UCLA activity, SF-12 physical component score, and HOOS at 6 months (UCLA activity: B = 0.03, P = .001; SF-12 physical component score: B = 0.15, P = .001; HOOS: B = 0.20; P = .008) and UCLA activity at 1 year (B = 0.02, P = .004). Furthermore, higher expectations predicted higher postoperative satisfaction and fulfillment of expectations at 6 months (satisfaction: B = 0.21, P < .001; fulfillment of expectations: B = 0.30, P