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首页> 外文期刊>Osteoarthritis and cartilage >Body mass index is not a clinically meaningful predictor of patient reported outcomes of primary hip replacement surgery: Prospective cohort study
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Body mass index is not a clinically meaningful predictor of patient reported outcomes of primary hip replacement surgery: Prospective cohort study

机译：体重指数不是患者报告的原发性髋关节置换手术结果的临床有意义的预测指标：前瞻性队列研究

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Objectives: To describe whether body mass index (BMI) is a clinically meaningful predictor of patient reported outcomes following primary total hip replacement (THR) surgery. Design: Combined data from prospective cohort studies. We obtained information from four cohorts of patients receiving primary THR for osteoarthritis: Exeter Primary Outcomes Study (EPOS) (n=1431); EUROHIP (n=1327); Elective Orthopaedic Centre (n=2832); and St. Helier (n=787). The exposure of interest was pre-operative BMI. Confounding variables included: age, sex, SF-36 mental health, comorbidities, fixed flexion, analgesic use, college education, OA in other joints, expectation of less pain, radiographic K&L grade, ASA grade, years of hip pain. The primary outcome was the Oxford Hip Score (OHS). Regression models describe the association of BMI on outcome adjusting for all confounders. Results: For a 5-unit increase in BMI, the attained 12-month OHS decreases by 0.78 points 95%CI (0.27-1.28), P-value 0.001. Compared to people of normal BMI (20-25), those in the obese class II (BMI 35-40) would have a 12-month OHS that is 2.34 points lower. Although statistically significant this effect is small and not clinically meaningful in contrast to the substantial change in OHS seen across all BMI groupings. In obese class II patients achieved a 22.2 point change in OHS following surgery. Conclusions: Patients achieved substantial change in OHS after THR across all BMI categories, which greatly outweighs the small difference in attained post-operative score. The findings suggest BMI should not present a barrier to access THR in terms of PROMs.
机译：目的：描述体重指数（BMI）是否是首次全髋置换（THR）手术后患者报告结局的临床意义预测指标。设计：来自前瞻性队列研究的组合数据。我们从四个因骨关节炎接受原发性THR的患者队列中获得了信息：埃克塞特原发性结局研究（EPOS）（n = 1431）; EUROHIP（n = 1327）;选修骨科中心（n = 2832）;和圣赫利尔（n = 787）。感兴趣的暴露是术前BMI。混杂变量包括：年龄，性别，SF-36精神健康，合并症，固定屈曲，镇痛药使用，大学教育，其他关节的OA，减轻疼痛的期望值，影像学K＆L评分，ASA评分，髋关节疼痛的年限。主要结果是牛津髋关节评分（OHS）。回归模型描述了BMI对所有混杂因素的结局调整的关联。结果：对于BMI增加5个单位，达到的12个月OHS降低了0.78点，95％CI（0.27-1.28），P值0.001。与正常BMI（20-25）的人相比，肥胖II级人群（BMI 35-40）的12个月OHS降低了2.34点。尽管在统计学上具有显着意义，但与在所有BMI组中看到的OHS的实质性变化相比，这种影响很小，并且在临床上没有意义。在肥胖的II类患者中，手术后OHS的变化达到22.2点。结论：所有BMI类别的患者在THR后OHS均发生了实质性变化，大大超过了术后得分的微小差异。研究结果表明，就PROM而言，BMI不应成为获得THR的障碍。

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