The impact of preoperative patient characteristics on health states after total hip replacement and related satisfaction thresholds: a cohort study

Health and Quality of Life Outcomes

Werner Plötz³  Matthias Hunger⁴  Christian Lausmann²  Rainer Wilkesmann²  Matthias Vogl¹ 

[1] Ludwig-Maximilians-Universität München, Munich School of Management, Institute of Health Economics and Health Care Management & Munich Center of Health Sciences, Munich, Germany;Krankenhaus Barmherzige Brüder München, Akademisches Lehrkrankenhaus der Technischen Universität München, Romanstraße 93, Munich 80639, Germany;Klinikum rechts der Isar, Technical University Munich, Munich, Germany;Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, P.O. Box 1129, Neuherberg 85758, Germany

关键词: Patient acceptable symptom state;    Satisfaction;    Total hip replacement;    EQ-5D, WOMAC;    Health-related quality of life;   

Others  :  1164554
DOI  :  10.1186/s12955-014-0108-1

 received in 2014-02-03, accepted in 2014-06-24,  发布年份 2014

【 摘 要 】

Background

The aim of the study was to analyze the effect of preoperative patient characteristics on health outcomes 6 months after total hip replacement (THR), to support patient¿s decision making in daily practice with predicted health states and satisfaction thresholds. By giving incremental effects for different patient subgroups, we support comparative effectiveness research (CER) on osteoarthritis interventions.

Methods

In 2012, 321 patients participated in health state evaluation before and 6 months after THR. Health-related quality of life (HRQoL) was measured with the EQ-5D questionnaire. Hip-specific pain, function, and mobility were measured with the WOMAC in a prospective observation of a cohort. The predictive capability of preoperative patient characteristics ¿ classified according to socio-demographic factors, medical factors, and health state variables ¿ for changes in health outcomes is tested by correlation analysis and multivariate linear regressions. Related satisfaction thresholds were calculated with the patient acceptable symptom state (PASS) concept.

Results

The mean WOMAC and EQ-5D scores before operation were 52 and 60 respectively (0 worst, 100 best). At the 6-month follow-up, scores improved by 35 and 19 units. On average, patients reported satisfaction with the operation if postoperative (change) WOMAC scores were higher than 85 (32) and postoperative (change) EQ-5D scores were higher than 79 (14).

Conclusions

Changes in WOMAC and EQ-5D scores can mainly be explained by preoperative scores. The lower the preoperative WOMAC or EQ-5D scores, the higher the change in the scores. Very good or very poor preoperative scores lower the probability of patient satisfaction with THR. Shared decision making using a personalized risk assessment approach provides predicted health states and satisfaction thresholds.

【 授权许可】

   
2014 Vogl et al.; licensee BioMed Central Ltd.

【 图 表 】

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