Predicting Patient Dissatisfaction Following Joint Replacement Surgery
Predicting Patient Dissatisfaction Following Joint Replacement Surgery
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DOI：
10.3899/jrheum.080295
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发表时间：
2008-12-01
影响因子：
3.9
通讯作者：
Mahomed, Nizar N.
中科院分区：
文献类型：
--
作者：
Gandhi, Rajiv;Davey, J. Roderick;Mahomed, Nizar N.
客观的。患者报告的全关节置换术后不满意的发生率高达 30%。我们的目的是确定术前患者层面对术后 1 年患者满意度的预测因素。方法。我们调查了 1720 名接受初次髋关节或膝关节置换手术的患者。记录相关协变量，包括人口统计数据、体重指数、性别、合并症和教育程度。分别使用西安大略麦克马斯特大学骨关节炎指数 (WOMAC) 和医疗结果研究简表 36 (SF-36) 量表在基线和 1 年随访时评估关节功能状态和患者生活质量。患者对手术的满意度通过 1 年随访时的 4 个调查问题来确定。结果。满意患者 (n = 1290) 和不满意患者 (n = 430) 之间的人口统计数据没有显着差异。 Logistic 回归模型显示，术前较低的 SF-36 心理健康评分可独立预测患者对手术的满意度，并针对所有相关协变量进行调整 (p < 0.05)。我们发现 1 年随访时患者满意度与 WOMAC 变化评分之间没有相关性 (p = 0.31)。结论。术前心理健康是了解患者对手术满意度时需要考虑的重要因素。应研究减少手术前心理困扰的干预措施，以确定它们是否可以改善接受关节置换手术的患者的主观结果。 （首次发布，2008 年 11 月 1 日；J Rheumatol 2008；35:2415-8；doi:10.3899/ jrheum.080295）
Objective. The incidence of patient-reported dissatisfaction following total joint arthroplasty can be up to 30%. Our aim was to identify the preoperative patient-level predictors of patient dissatisfaction 1 year after surgery.Methods. We surveyed 1720 patients undergoing primary hip or knee replacement surgery. Relevant covariates including demographic data, body mass index, sex, comorbidities, and education were recorded. Joint functional status and patient quality of life were assessed at baseline and at 1-year followup with the Western Ontario McMaster University Osteoarthritis Index (WOMAC) and Medical Outcomes Study Short Form-36 (SF-36) scales, respectively. Patient satisfaction with surgery was determined with 4 survey questions at 1-year followup.Results. There were no significant differences in demographic data between satisfied (n = 1290) and dissatisfied patients (n = 430). Logistic regression modeling showed that a lower preoperative SF-36 Mental Health score independently predicted patient dissatisfaction with surgery, adjusted for all relevant covariates (p < 0.05). We found no correlation between patient satisfaction and WOMAC change scores at 1-year followup (p = 0.31).Conclusion. Preoperative mental health is an important factor to consider when understanding patient satisfaction with surgery. Interventions to reduce psychological distress prior to surgery should be studied to determine if they may improve subjective outcomes of patients undergoing joint replacement surgery. (First Release Nov 1 2008; J Rheumatol 2008;35:2415-8; doi:10.3899/ jrheum.080295)