Patient-reported outcomes in the Swedish Hip Arthroplasty Register RESULTS OF A NATIONWIDE PROSPECTIVE OBSERVATIONAL STUDY
Patient-reported outcomes in the Swedish Hip Arthroplasty Register RESULTS OF A NATIONWIDE PROSPECTIVE OBSERVATIONAL STUDY
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DOI：
10.1302/0301-620x.93b7.25737
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发表时间：
2011-07-01
影响因子：
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通讯作者：
Garellick, G.
中科院分区：
文献类型：
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作者：
Rolfson, O.;Karrholm, J.;Garellick, G.
我们提出了一项全国性、前瞻性、观察性随访计划的发展和结果，包括瑞典髋关节置换术登记的患者报告的结果测量（PROMs）。该计划始于2002年，并逐渐扩大到瑞典所有进行全髋关节置换术的单位。自我管理的PROMs方案包括EQ-5D仪器，Charnley类分类和疼痛和满意度的视觉模拟量表。目前的分析包括34960例全髋关节置换术患者，术前和术后1年填写完整的问卷。符合全髋关节置换术条件的患者通常报告与健康相关的生活质量较低，并遭受疼痛。术后1年，平均EQ-5D指数高于年龄和性别匹配人群的水平，疼痛明显减轻（p < 0.001）。女性、年轻患者和Charnley C型患者术前EQ-5D指数分别低于男性、老年患者和Charnley a型或B型患者（均p < 0.001）。在Charnley C类多变量回归分析中，男性性别和年龄越大，与健康相关的生活质量改善越少（p < 0.001）。在全国范围内实施PROMs计划需要一个结构化的组织和有效的数据采集。患者对登记处的反应率很好。持续收集PROMs使地方和国家的改进工作得以开展，并使进一步的健康经济评估成为可能。
We present the development and results of a nationwide, prospective, observational follow-up programme including patient-reported outcome measures (PROMs) for the Swedish Hip Arthroplasty Register. The programme started in 2002 and has gradually expanded to include all units performing total hip replacement in Sweden. The self-administered PROMs protocol comprises the EQ-5D instrument, the Charnley class categorisation and visual analogue scales for pain and satisfaction. These current analyses include 34 960 total hip replacements with complete pre- and one-year post-operative questionnaires.Patients eligible for total hip replacement generally report low health-related quality of life and suffer from pain. One year post-operatively the mean EQ-5D index increased to above the level of an age-and gender-matched population, with a considerable reduction of pain (p < 0.001). Females, younger patients and those with Charnley category C reported a lower EQ-5D index pre-operatively than males, older patients and Charnley category A or B, respectively (all p < 0.001). In a multivariable regression analysis Charnley category C, male gender and higher age were associated with less improvement in health-related quality of life (p < 0.001).Nationwide implementation of a PROMs programme requires a structured organisation and effective data capture. Patients' response rates to the Registry are good. The continuous collection of PROMs permits local and national improvement work and allows for further health-economic evaluation.