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Related Concept Videos

Guidelines for Writing Outcome01:11

Guidelines for Writing Outcome

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When developing expected outcomes for a patient care plan, the nurse should adhere to the following recommendations:
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
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Outcomes Vary Significantly Using a Tiered Approach To Define Success After Total Hip Arthroplasty.

Christopher N Carender1, Morgan L Gulley1, Ayushmita De2

  • 1Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.

The Iowa Orthopaedic Journal
|June 29, 2023
PubMed
Summary

Clinical outcomes after total hip arthroplasty (THA) vary significantly based on patient-reported outcome measures (PROMs). Age and sex are key demographic factors influencing success after THA.

Keywords:
MCIDPROMminimally clinically important differencepatient-reported outcome measurestotal hip arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Biostatistics
  • Patient-Reported Outcomes

Background:

  • Total hip arthroplasty (THA) outcomes are typically assessed using patient-reported outcome measures (PROMs).
  • Defining clinical success post-THA requires standardized, progressively stringent criteria.
  • Understanding demographic influences on THA success is crucial for patient stratification.

Purpose of the Study:

  • To evaluate primary THA clinical outcomes at one year using tiered success definitions.
  • To identify demographic variables associated with achieving clinical success after primary THA.

Main Methods:

  • Analysis of 7,001 primary THAs from the American Joint Replacement Registry (AJRR) (2012-2020).
  • Inclusion of patients with pre- and 1-year postoperative PROMs: HOOS, JR, WOMAC-Pain, and WOMAC-Function.
  • Calculation of minimal clinically important difference (MCID), patient acceptable symptom state (PASS), and substantial clinical benefit (SCB) rates.
  • Logistic regression to assess demographic associations with clinical success.

Main Results:

  • Significant improvements observed in HOOS, JR (37), WOMAC-Pain (39), and WOMAC-Function (41) (p<0.0001).
  • Achievement rates varied by metric: MCID (68-93%), PASS (47-84%), SCB (68-84%).
  • Age and sex were the most significant demographic factors impacting clinical success.

Conclusions:

  • Clinical outcomes after primary THA demonstrate considerable variability at one year when assessed from the patient's perspective.
  • Tiered approaches for interpreting PROMs are recommended for future research and clinical practice.
  • Demographic factors, particularly age and sex, play a significant role in patient-reported success after THA.