Maintaining a hip registry for 25 years. Mayo Clinic experience.
Maintaining a hip registry for 25 years. Mayo Clinic experience.
复制标题
维持髋关节登记长达 25 年。
DOI：
--
复制
发表时间：
1997
影响因子：
4.2
通讯作者：
B. Morrey
中科院分区：
文献类型：
--
作者：
Daniel J. Berry;Mary Kessler;B. Morrey
建立了在作者所在机构进行的所有全关节置换术的计算机数据库。迄今为止，该登记处包含56,000多例关节置换术的信息，其中30,000多例涉及髋关节。登记的目的是确定全髋关节置换术的有效性，作为植入物设计、手术技术和患者选择的功能。此外，通过维护和更新患者记录，有关成功或预期失败的数据可以传达给患者。最后，该资源将提供可靠的信息，可以传达给骨科社区。术后1年、2年和5年及以后每隔5年通过检查或信件或电话问卷对患者进行常规评估。每个间隔的随访率约为95%。如果患者年龄较大，手术后时间较长，或者住得离诊所较远，那么他们更有可能通过问卷回答（而不是亲自就诊）。数据由五名全职员工收集，包括专门分配给该项目的计算机和统计支持。联合登记的年度预算超过40万美元。不幸的是，这一努力的未来受到以下需求的挑战：(1)显示活动的成本效益；(2)更新和验证作为数据库输入的结果工具；(3)在不鼓励患者回访或本地评估的医疗经济环境下保持令人满意的随访率。
A computerized database was established for all total joint replacements done at the authors' institution. To date the registry contains information on more than 56,000 arthroplasties of which more than 30,000 involve the hip. The registry was designed to determine the effectiveness of total hip arthroplasty as a function of implant design, surgical technique, and patient selection. Furthermore, by maintaining and updating the patient record, data regarding success or anticipated failure could be communicated to the patient. Finally, this resource would provide reliable information that could be communicated to the orthopedic community. Patients are routinely evaluated at 1, 2, and 5 years postoperatively and at 5-year intervals thereafter by examination or letter or telephone questionnaire. Followup of patients at each interval is approximately 95%. Patients are more likely to respond by questionnaire (rather than be seen in person) if they are older, if a longer time has elapsed since surgery, or if they live a long distance from the clinic. Data are collected by five full time employees including computer and statistical support specifically assigned to the project. The annual joint registry budget is in excess of $400,000. Unfortunately, the future of this endeavor is challenged by the needs to: (1) show cost effectiveness of the activity; (2) update and validate outcomes instruments used as input into the database; and (3) maintain satisfactory followup rates in a medical economic environment that often discourages patient return visits or local assessment.