Latent Class Growth Analysis predicts long term pain and function trajectories in total knee arthroplasty: a study of 689 patients
Latent Class Growth Analysis predicts long term pain and function trajectories in total knee arthroplasty: a study of 689 patients
复制标题
DOI：
10.1016/j.joca.2015.07.005
复制
发表时间：
2015-12-01
影响因子：
7
通讯作者：
Choong, P. F. M.
中科院分区：
文献类型：
--
作者：
Dowsey, M. M.;Smith, A. J.;Choong, P. F. M.
目的：根据人工全膝关节置换术(TKA)后1~5年的膝关节疼痛和功能状态分组。方法：2006年至2008年，同一中心的689例患者接受了初次全膝关节置换。术前、术后每年收集膝关节协会评分(KSS)。根据患者术后1-5年的膝关节疼痛轨迹和功能，采用潜在类别增长分析(LCGA)对患者进行分组。结果：LCGA将膝关节持续性中度疼痛分为一类(22.0%)。中度疼痛轨迹组成员的预测因子(OR，95%CI)为：术前每10分SF12精神成分概要(MCS)(0.65，0.54-0.79)和每10分身体成分概要(PCS)(0.50，0.33-0.76)，Charlson共病指数(CCI)1(1.70，1.07-2.69)和>；=2(2.82，1.59-4.81)和没有电脑导航(2.26，1.09-4.68)。LCGA还确定了一类功能不佳的患者(23.0%)。女性(3.31，1.95~5.63)，每10年超前年龄(2.27，1.69~3.02)，术前每10分PCS(0.50，0.33~0.74)，肥胖(1.69，1.05~2.72)，病态肥胖(3.12，1.55~6.27)和CCI>是低功能轨道组成员的预测因素；=2(2.50，1.41-4.42)。结论：TKA不良反应的可修改预测因素包括基线合并症、身心健康和肥胖。这为临床医生提供了有用的信息，以告知患者TKA的预期长期结果，并开发预测算法，以识别哪些患者的手术反应较差的可能性很高。(C)2015年，爱思唯尔有限公司代表国际骨性关节炎研究会出版。
Objective: To characterize groups of subjects according to their trajectory of knee pain and function over 1 to 5 years post total knee arthroplasty (TKA).Methods: Patients from one centre who underwent primary TKA (N = 689) between 2006 and 2008. The Knee Society Score (KSS) was collected pre-operatively and annually post-operatively. Latent Class Growth Analysis (LCGA) was used to classify groups of subjects according to their trajectory of knee pain and function over 1-5 years post-surgery.Results: LCGA identified a class of patients with persistent moderate knee pain (22.0%). Predictors (OR, 95% CI) of moderate pain trajectory class membership were pre-surgery SF12 mental component summary (MCS) per 10 points (0.65, 0.54-0.79) and physical component summary (PCS) per 10 points (0.50, 0.33-0.76), Charlson Comorbidity Index (CCI) one (1.70, 1.07-2.69) and >= two (2.82, 1.59-4.81) and the absence of computer-navigation (2.26, 1.09-4.68). LCGA also identified a class of patients with poor function (23.0%). Predictors of low function trajectory class membership were, female sex (3.31,1.95-5.63), advancing age per 10 years (2.27, 1.69-3.02), pre-surgery PCS per 10 points (0.50, 0.33-0.74), obesity (1.69,1.05-2.72), morbid obesity (3.12, 1.55-6.27) and CCI >= two (2.50, 1.41-4.42).Conclusions: Modifiable predictors of poor response to TKA included baseline co-morbidity, physical and mental well-being and obesity. This provides useful information for clinicians in terms of informing patients of the expected course of longer term outcomes of TKA and for developing prediction algorithms that identify patients in whom there is a high likelihood of poor surgical response. (C) 2015 Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International.