高区域剥夺指数与TKA后未达到患者可以接受的症状状态有关
Matthew J Hadad1, Ignacio Pasqualini, Alison K Klika
1Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
Clinical orthopaedics and related research
|April 3, 2024
概括
通过区域剥夺指数 (ADI) 衡量的社会经济地位,影响了膝关节全关节整形术 (TKA) 后的患者满意度. 较高的ADI与更糟糕的结果有关,这表明需要为接受TKA的贫困患者提供有针对性的支持.
科学领域:
- 整形外科手术 整形外科手术
- 医疗保健服务研究 医疗服务研究
- 健康的社会经济决定因素
背景情况:
- 区域贫困指数 (ADI) 量化了患者的社会经济贫困.
- 之前的研究将ADI与全膝关节整形术 (TKA) 后医疗保健利用率的增加联系在一起.
- 在TKA后,ADI和患者报告的结果指标 (PROMs) 之间的关联仍然不清楚.
研究的目的:
- 为了确定ADI是否与实现膝关节损伤和骨关节炎结局得分 (KOOS) 疼痛,关节置换 (JR) 和体力功能 (PS) 的最低临床重要差异 (MCID) 相关.
- 评估ADI是否与达到KOOS疼痛,JR和PS后TKA的患者可接受的症状状态 (PASS) 值有关.
主要方法:
- 在2016年至2021年期间,对8813名接受单边TKA治疗的患者进行了回顾性分析.
- 在基线和1年随访时评估的PROM (KOOS疼痛,JR,PS).
- 多变量后勤回归分析了ADI五分位数与MCID和PASS成就的关联,控制了人口统计数据.
主要成果:
- ADI与实现KOOS疼痛,JR或PS的MCID没有关联.
- 更高的ADI独立地增加了在KOOS疼痛 (OR 1.34) 和JR (OR 1.29) 中无法实现PASS的风险.
- 在较高的ADI和未达到KOOS PS (OR1.09) 的PASS之间没有发现显著的关联.
结论:
- 社会经济因素影响患者对TKA后整体疼痛和功能的感知,但没有感知到改善.
- 来自贫困地区的患者可能会受益于有针对性的干预措施,例如运输和护理协调支持.
- 需要进一步的研究来了解为什么社会经济劣势会影响PASS,而不是TKA后的MCID成就.
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