Association between socioeconomic status and pain, function and pain catastrophizing at presentation for total knee arthroplasty.
Association between socioeconomic status and pain, function and pain catastrophizing at presentation for total knee arthroplasty.
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DOI：
10.1186/s12891-015-0475-8
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发表时间：
2015-02-07
影响因子：
2.3
通讯作者：
Losina E
中科院分区：
文献类型：
--
作者：
Feldman CH;Dong Y;Katz JN;Donnell-Fink LA;Losina E
与社会经济地位较低的患者相比，社会经济地位较高的患者的全膝关节置换术（TKA）结局更好。SES与影响TKA使用的因素之间的关系尚未得到充分研究。我们研究了SES与TKA疼痛、功能和疼痛灾难性表现之间的关系。在学术中心接受TKA的患者中，我们获得了术前疼痛和功能状态（WOMAC指数0 - 100，100最差）、疼痛灾难性（PCS，≥ 16高）和心理健康（MHI-5，<68差）。我们使用教育作为代理来描述个人级别的SES，并使用将地理编码地址与美国人口普查数据联系起来的有效复合索引来描述区域级别的SES。我们测量了这些指标与疼痛、功能和疼痛灾难化之间的关联，并根据年龄、性别和BMI进行了调整。在316例患者中，平均年龄为65.9岁（SD 8.7），59%为女性，88%为白人; 17%的受教育程度低于大学，62%为大学毕业生。地区SES指数评分中位数为59（美国中位数为51）。双变量分析表明，较高的个人和地区水平的SES与较低的疼痛，较高的功能和较少的疼痛灾难化之间存在相关性（所有p <0.05）。调整后的分析表明，较高的个人和地区水平的SES和更好的功能和更少的疼痛之间的统计学显着的关联。在该队列中，个体和区域水平SES较高的患者在TKA时的疼痛较低，功能较好。需要进一步研究来评估在这些SES较高的组中进行TKA的适当疼痛和功能水平。本文的在线版本（doi：10.1186/s12891 - 015 - 0475 - 8）包含补充材料，可供授权用户使用。
Patients with higher socioeconomic status (SES) are shown to have better total knee arthroplasty (TKA) outcomes compared to those with lower SES. The relationship between SES and factors that influence TKA use is understudied. We examined the association between SES and pain, function and pain catastrophizing at presentation for TKA. In patients undergoing TKA at an academic center, we obtained preoperative pain and functional status (WOMAC Index 0–100, 100 worst), pain catastrophizing (PCS, ≥16 high), and mental health (MHI-5, <68 poor). We described individual-level SES using education as a proxy, and area-level SES using a validated composite index linking geocoded addresses to U.S. Census data. We measured associations between these indicators and pain, function and pain catastrophizing, adjusting for age, sex and BMI. Among 316 patients, mean age was 65.9 (SD 8.7), 59% were female, and 88% were Caucasian; 17% achieved less than college education and 62% were college graduates. The median area SES index score was 59 (U.S. median 51). Bivariable analyses demonstrated associations between higher individual- and area-level SES and lower pain, higher function and less pain catastrophizing (all p<0.05). Adjusted analyses demonstrated statistically significant associations between higher individual- and area-level SES and better function and less pain. In this cohort, patients with higher individual- and area-level SES had lower pain and higher function at the time of TKA than lower SES patients. Further research is needed to assess what constitutes appropriate levels of pain and function to undergo TKA in these higher SES groups. The online version of this article (doi:10.1186/s12891-015-0475-8) contains supplementary material, which is available to authorized users.
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影响因子：
3.2
作者：
Ackerman, Liana N.;Ademi, Zanfina;Liew, Danny
通讯作者：
Liew, Danny
影响因子：
--
作者：
Hawker, GA;Wright, JG;Badley, EA
通讯作者：
Badley, EA
影响因子：
3
作者：
Epstein, AM;Weissman, JS;Piana, RN
通讯作者：
Piana, RN
影响因子：
2.9
作者：
Edwards, Robert R.;Goble, Layne;Haythornthwaite, Jennifer
通讯作者：
Haythornthwaite, Jennifer
DOI：
10.1186/2052-1847-5-2
发表时间：
2013-03-28
期刊：
BMC sports science, medicine & rehabilitation
影响因子：
--
作者：
Desmeules F;Dionne CE;Belzile ÉL;Bourbonnais R;Champagne F;Frémont P
通讯作者：
Frémont P