Dissatisfaction After Total Hip Arthroplasty Associated With Preoperative Patient-Reported Outcome Phenotypes

Orr M.N.; Klika A.K.; Emara A.K.Barsoum W.K.Molloy R.M.Krebs V.E.Bloomfield M.R.Murray T.G.Mesko N.W.Brooks P.J.Stearns K.L.Patel P.D.Hampton R.J.Higuera C.A.George J.W.Greene K.A.McLaughlin J.P.Riesgo A.M.Piuzzi N.S.

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Dissatisfaction After Total Hip Arthroplasty Associated With Preoperative Patient-Reported Outcome Phenotypes

机译：Dissatisfaction After Total Hip Arthroplasty Associated With Preoperative Patient-Reported Outcome Phenotypes

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? 2022 Elsevier Inc.Background: Patient satisfaction is indicative of the quality of care in the value-driven healthcare model. The Patient Acceptable Symptom State (PASS) is a dichotomous outcome tool measuring the highest level of symptom beyond which a patient considers him/herself well. The purpose of the present study was to identify combined preoperative phenotypes of PROMs associated with not achieving PASS at 1 year following total hip arthroplasty (THA) and to associate such phenotypes with hospital utilization parameters. Methods: A prospective institutional cohort of 4,034 patients who underwent primary THA for osteoarthritis (OA) with 1-year follow-up was included. Preoperative scores on Hip Disability and Osteoarthritis Outcome Score (HOOS)-pain, HOOS physical short form-(PS), and Veteran's Rand-12 (VR-12) mental component summary-(MCS) were used to develop phenotypes. Associations between preoperative ‘phenotype’ and 1-year PASS, discharge disposition, prolonged length of stay, 90-day readmission, and 1-year reoperation were evaluated using multivariate regression. Results: 10.6 (427/4,043) reported their state as ‘not satisfactory’ at 1 year. The phenotypes were the only preoperative factors to demonstrate the increased likelihood of 1-year dissatisfaction. Only phenotypes with lower than average preoperative MCS demonstrated this association. Low scores in all presently measured PROMs (Pain-PS-MCS-) was associated with double the odds of 1-year dissatisfaction (P < .001), 2.43 times the odds of nonhome discharge and 2.2 times the odds of prolonged LOS. Conclusions: Patients with lower preoperative scores across multiple PROMs have increased odds of dissatisfaction after THA; and assessing pain, function, and MCS concomitantly (as phenotypes) may support identifying patients at risk for not achieving a satisfactory outcome.

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《The Journal of arthroplasty》 |2022年第7期|S498-S509|共12页
作者
Orr M.N.; Klika A.K.; Emara A.K.Barsoum W.K.Molloy R.M.Krebs V.E.Bloomfield M.R.Murray T.G.Mesko N.W.Brooks P.J.Stearns K.L.Patel P.D.Hampton R.J.Higuera C.A.George J.W.Greene K.A.McLaughlin J.P.Riesgo A.M.Piuzzi N.S.;
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Department of Orthopaedic Surgery Cleveland Clinic;

Department of Orthopaedic Surgery Cleveland Clinic Florida;

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正文语种英语
中图分类骨科学（运动系疾病、矫形外科学）;
关键词
function; pain; patient acceptable symptomatic state (PASS); patient-reported outcomes (PROMs); phenotypes; satisfaction; total hip arthroplasty (THA);

Dissatisfaction After Total Hip Arthroplasty Associated With Preoperative Patient-Reported Outcome Phenotypes

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