Determinants of Health-Related Quality of Life Following Elective Total Hip Replacement

Hopman, Wilma M.; Mantle, Michelle; Towheed, Tanveer; Mackenzie, Thomas A.

doi:10.1177/106286069901400302

Cited by 23 publications

(11 citation statements)

References 14 publications

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“…Even when allowance is made for possible confounding effects, the long‐term improvement in the physical functioning of the cases is striking when set against the decline that occurred in controls. This observation is consistent with findings from other studies (2–13) and suggests that the benefits of THA are often substantial and sustained. In contrast, mental health improved less over followup, and no more in cases than in controls.…”

Section: Discussionsupporting

confidence: 92%

“…At this time point, patients were found to have significantly worse physical functioning when compared with controls; older age at surgery and preoperative pain appeared to predict a worse physical outcome. This study is in accord with others in suggesting that the greatest benefit of surgery on quality of life relates to pain and physical functioning, but that improvements may also be found in social functioning and mental health (2–13). The treatment appears to be effective at all ages (2, 5, 13–15), with greater benefits in patients with poorer preoperative health‐related quality of life (2, 4, 16).…”

Section: Introductionsupporting

confidence: 90%

“…In contrast, mental health improved less over followup, and no more in cases than in controls. Some earlier investigations have suggested that THA benefits mental health as well as physical health (3–5, 7, 8, 10–12). Perhaps the difference of these studies from our own lies in the mental health of our cases prior to surgery.…”

Section: Discussionmentioning

confidence: 99%

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Long‐term outcome following total hip arthroplasty: A controlled longitudinal study

Cushnaghan¹,

Coggon²,

Reading³

et al. 2007

Arthritis & Rheumatism

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Objective. To assess long-term outcome and predictors of prognosis following total hip arthroplasty (THA) for osteoarthritis (OA). Methods. We studied 282 patients from 2 English health districts ϳ8 years after THA, along with 295 controls selected from the general population. Baseline data were collected by interview and examination, on sex, age, comorbidity, body mass index (BMI), and Short Form 36 (SF-36) functional status, and preoperative radiographic severity of OA was graded. Functional status was reassessed at followup by postal questionnaire. Predictors of change in physical functioning were analyzed by linear regression. Results. Over followup, cases who had THA reported a median improvement of 10 points in SF-36 score for physical functioning, whereas in controls there was a median deterioration of 10 points (P < 0.0001). Mental health improved by a median of 12 points in both cases and controls. Change in physical functioning was significantly worse in women and at older ages among both cases and controls. In cases, Croft grade 5 OA was associated with a physical functioning score improvement 19.4 points (95% confidence interval 7.7, 31.2) greater than the improvement in grades 0 -3, but BMI was unrelated to change in physical functioning. Conclusion. Improvements in physical functioning following THA for OA are sustained in the long term and are more frequent in patients with more severe radiographic features preoperatively. We found no indication that patients who are overweight benefit less from THA, but further evidence is needed on the prognostic influence of more severe obesity.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionsupporting

confidence: 90%

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Long‐term outcome following total hip arthroplasty: A controlled longitudinal study

Cushnaghan¹,

Coggon²,

Reading³

et al. 2007

Arthritis & Rheumatism

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“…Many predictors of SF-36 scores have been investigated [5,9,10], the most common being preoperative SF-36 scores, which are positively correlated with improvement in SF-36 scores after surgery [11,12]. Some studies have suggested medical care characteristics (medication, type of prosthesis), physician-related characteristics (sex, experience) [13] and effective patient-physician communication [14] as potential predictors of improvement in SF-36 score. Indeed, if health problems and personal factors are major HRQoL determinants, environmental factors, as defined by The International Classification of Functioning, Disability and Health, are also major determinants.…”

Section: Introductionmentioning

confidence: 99%

Satisfaction with care after total hip or knee replacement predicts self-perceived health status after surgery

Baumann

Rat

Osnowycz³

et al. 2009

BMC Musculoskelet Disord

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BackgroundInpatient satisfaction with care is a standard indicator of the quality of care delivered during hospitalization. Total hip and knee replacement (THR/TKR) for osteoarthritis (OA) are among the most successful orthopaedic interventions having a positive impact on health-related quality of life (HRQoL). The aim was to evaluate the effect of satisfaction shortly after hospital discharge on 1-month, 6-month and 1-year Medical Outcomes Study 36-item Short Form (SF-36) scores for OA patients after THR and TKR, controlling for patient characteristics, clinical presentation and preoperative SF-36 scores.MethodsA multicenter prospective cohort study recruited 231 patients with OA scheduled to receive THR or TKR. Satisfaction was assessed by the Patients Judgment of Hospital Quality (PJHQ) questionnaire and HRQoL by the SF-36 questionnaire. Linear models for repeated measures assessed the relation between satisfaction (scores were dichotomized) and postoperative SF-36 scores.ResultsOf 231 participants, 189 were followed up 12 months after discharge (mean age 69 SD = 8; 42.6% male). The mean length of hospital stay was 13.5 (SD = 4) days. After adjustment for preoperative SF-36 scores, sociodemographic and clinical patient characteristics, satisfied patients (PJHQ score > 70) had higher SF-36 scores 1 year after surgery than did less-satisfied patients. Admission, medical care, and nursing and daily care scores mainly predicted bodily pain, mental health, social functioning, vitality and general health scores of the SF-36.ConclusionBesides being a quality-of-care indicator, immediate postoperative patient satisfaction with care may bring a new insight into clinical practice, as a predictor of self-perceived health status after surgery.

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“…As a result, HRQOL is used as an outcome variable following specific interventions or events. For example, HRQOL has been used as an outcome measure following joint replacements (Benroth & Gawande, 1999; Fortin et al, 1999; Hopman, Mantle, Towheed, & MacKenzie, 1999; Jones, Voak‐lander, Johnston, & Suarez‐Almazor, 2000; Knutsson & Bergbom, 1999; Lieberman et al, 1997; O'Boyle, McGee, Hickey, O'Malley, & Joyce, 1992; Randell et al, 2000), hip fractures (Borgquist, Nilsson, Lindelow, Wiklund, & Thorngren, 1992; Randell et al, 2000), or other surgical procedures, such as prostatectomy or vascular surgery (Cleary, Greenfield, & McNeil, 1991; Hayward et al, 1999; Holtzman, Caldwell, Walvatne, & Kane, 1999; Mangione et al, 1997). HRQOL also has been used to assess the impact over time of specific diseases or problems, such as rheumatoid arthritis (Kosinski, Zhao, Dedhiya, Osterhaus, & Ware, 2000) or fear of falling (Cummings, Salkeld, Thomas, & Szonyi, 2000).…”

mentioning

confidence: 99%

Health-Related Quality of Life: Is It a Good Indicator of Function Post THR?

Orwig

Wehren

Hawkes

et al. 2005

Rehabilitation Nursing

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The purpose of this study was to explore the impact of health-related quality of life (HRQOL) measured with the Short Form Health Survey (SF-36) on Functional Recovery Status (physical and psychosocial recovery status) at base-line, 2 months, 6 months, and 12 months following total hip replacement (THR). A secondary analysis was performed using data gathered from a sample of 271 older adults post THR. Four empirically based hypothesized models were tested. None of the models fit the data, with each having significant chi2 values and chi2 /df ratios greater than 3. Different dimensions of HRQOL at baseline, 2, 6, and 12 months were related to physical recovery status, and none of the 8 dimensions of the SF-36 was significantly related to psychosocial recovery status. Overall, the results of this study do not support the hypothesis that HRQOL, as measured by the SF-36, comprehensively explains functional recovery status following THR. Clinically, these findings may be applicable to individuals at risk for poor recovery. They also may prompt practitioners to consider alternative factors that influence psychosocial recovery.

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Determinants of Health-Related Quality of Life Following Elective Total Hip Replacement

Cited by 23 publications

References 14 publications

Long‐term outcome following total hip arthroplasty: A controlled longitudinal study

Long‐term outcome following total hip arthroplasty: A controlled longitudinal study

Satisfaction with care after total hip or knee replacement predicts self-perceived health status after surgery

Health-Related Quality of Life: Is It a Good Indicator of Function Post THR?

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