Important patient characteristics differ prior to total knee arthroplasty and total hip arthroplasty between Switzerland and the United States.
Important patient characteristics differ prior to total knee arthroplasty and total hip arthroplasty between Switzerland and the United States.
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DOI：
10.1186/s12891-016-1372-5
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发表时间：
2017-01-11
影响因子：
2.3
通讯作者：
Lübbeke A
中科院分区：
文献类型：
--
作者：
Franklin PD;Miozzari H;Christofilopoulos P;Hoffmeyer P;Ayers DC;Lübbeke A
全膝关节置换术 (TKA) 和髋关节置换术 (THA) 的结果通常在国际上具有普遍性。患者依赖性因素和术前症状水平可能因国家而异。我们比较了两个大队列的术前患者和临床特征，一个在瑞士，另一个在美国。在瑞士一家大型医院和美国全国样本中进行的所有选择性初次全膝关节置换术和全髋关节置换术中，前瞻性地收集了患者特征。数据包括年龄、性别、教育水平、BMI、诊断、医疗共病、PROM（WOMAC 疼痛/功能）、全球健康 (SF-12)。对 6,680 个主要 TKA（美国）和 823 个 TKA（瑞士）进行了评估。美国与瑞士的 TKA 患者更年轻（平均年龄 67 岁 vs. 72 岁），更肥胖（BMI ≥30 55% vs. 43%），受教育程度较高，患心脏病的比例也更高。瑞士患者的术前 WOMAC 疼痛评分较低（41 比 52），但术前身体残疾程度相当。评估了 4,647 个初级 THA（美国）和 1,023 个 THA（瑞士）。美国患者与瑞士患者相比更年轻（65 岁 vs. 68 岁）、更肥胖（BMI ≥30：38% vs. 24%）、受教育程度更高、患糖尿病的比例更高。瑞士患者的术前 WOMAC 疼痛评分较低（40 分对 48 分）。据报告，身体残疾程度相当，但瑞士患者的心理健康得分较低。我们发现美国和瑞士队列在术前患者特征和疼痛水平方面存在显着差异，这对于 TKA/THA 结果的跨文化比较具有潜在的重要意义。国家登记处的报告缺乏详细的患者信息，而这些数据表明需要对患者因素进行充分的风险调整。
Outcomes after total knee (TKA) and hip (THA) arthroplasty are often generalized internationally. Patient-dependent factors and preoperative symptom levels may differ across countries. We compared preoperative patient and clinical characteristics from two large cohorts, one in Switzerland, the other in the US. Patient characteristics were collected prospectively on all elective primary TKAs and THAs performed at a large Swiss hospital and in a US national sample. Data included age, sex, education level, BMI, diagnosis, medical co-morbidities, PROMs (WOMAC pain/function), global health (SF-12). Six thousand six hundred eighty primary TKAs (US) and 823 TKAs (Swiss) were evaluated. US vs. Switzerland TKA patients were younger (mean age 67 vs. 72 years.), more obese (BMI ≥30 55% vs. 43%), had higher levels of education, more cardiac disease. Swiss patients had lower preoperative WOMAC pain scores (41 vs. 52) but pre-operative physical disability were comparable. 4,647 primary THAs (US) and 1,023 THAs (Swiss) were evaluated. US vs. Switzerland patients were younger (65 vs. 68 years.), more obese (BMI ≥30: 38% vs. 24%), had higher levels of education, more diabetes. Swiss patients had lower preoperative WOMAC pain scores (40 vs. 48 points). Physical disability was reported comparable, but Swiss patients indicated lower mental health scores. We found substantial differences between US and Swiss cohorts in pre-operative patient characteristics and pain levels, which has potentially important implications for cross-cultural comparison of TKA/THA outcomes. Reports from national registries lack detailed patient information while these data suggest the need for adequate risk adjustment of patient factors.