Socioeconomic status affects the early outcome of total hip replacement
Socioeconomic status affects the early outcome of total hip replacement
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DOI：
10.1302/0301-620x.93b4.25717
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发表时间：
2011-04-01
影响因子：
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通讯作者：
Biant, L. C.
中科院分区：
文献类型：
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作者：
Clement, N. D.;Muzammil, A.;Biant, L. C.
这项前瞻性研究评估了全髋关节置换术后一年社会剥夺对牛津髋关节评分的影响。对1312例因症状性骨关节炎接受1359例初次全髋关节置换术的患者进行了为期35个月的分析。社会剥夺使用卡斯泰尔斯指数进行评估。与富裕的患者相比，那些最贫困的患者在更早的年龄接受手术（p = 0.04），有更多的合并症（p = 0.02），症状严重程度增加（p = 0.001），并且对他们的结局不满意（p = 0.03）。相对于术前所有社会经济分类的评分，12个月时牛津评分均显著改善（p < 0.001）。调整混杂变量后，社会剥夺是12个月时牛津评分平均改善的显著独立预测因素（p = 0.001）。全髋关节置换术后脱位风险增加（优势比5.3，p < 0.001），术后90天死亡率增加（优势比3.2，p = 0.02），全髋关节置换术后脱位风险和早期死亡率受患者社会经济状况的影响
This prospective study assessed the effect of social deprivation on the Oxford hip score at one year after total hip replacement. An analysis of 1312 patients undergoing 1359 primary total hip replacements for symptomatic osteoarthritis was performed over a 35-month period. Social deprivation was assessed using the Carstairs index. Those patients who were most deprived underwent surgery at an earlier age (p = 0.04), had more comorbidities (p = 0.02), increased severity of symptoms at presentation (p = 0.001), and were not as satisfied with their outcome (p = 0.03) compared with more affluent patients. There was a significant improvement in Oxford scores at 12 months relative to pre-operative scores for all socioeconomic categories (p < 0.001). Social deprivation was a significant independent predictor of mean improvement in Oxford scores at 12 months, after adjusting for confounding variables (p = 0.001). Deprivation was also associated with an increased risk of dislocation (odds ratio 5.3, p < 0.001) and mortality at 90 days (odds ratio 3.2, p = 0.02).Outcome, risk of dislocation and early mortality after a total hip replacement are affected by the socioeconomic status of the patient