反保 THAs 隔一年多:每次手术后,PROM 和医疗保健利用有所不同吗?
Alvaro Ibaseta1, Ignacio Pasqualini, Shujaa T Khan
1Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
Clinical orthopaedics and related research
|December 11, 2024
概括
第二次关节整形术 (THA) 后的结果与第一次THA相似,改善和医疗保健使用情况相似. 然而,在两种手术后,显著的比例的患者经历了不充分的疼痛缓解.
科学领域:
- 整形外科手术 整形外科手术
- 重建性手术是一种重建性手术.
- 患者的治疗结果.
背景情况:
- 经过第二次关节整形手术 (THA) 超过一年后的患者可能有不同的恢复模式.
- 在分阶段双边THA后,对临床显著改善和医疗保健利用的理解有限.
研究的目的:
- 为了比较患者报告的结果指标 (PROMs) 在基线和1年后THA第一次与第二次关节置换.
- 评估在达到最低临床重要差异 (MCID) 和患者可接受的症状状态 (PASS) 值方面的差异.
- 评估在第一个和第二个THA之间医疗保健利用 (出院安排,停留时间,90天再接收) 的变化.
主要方法:
- 从2016年至2021年间,对654名患者进行逆侧THA>1年间隔的回顾性分析.
- 在手术前和THA后1年收集的PROMs (HOOS-pain,HOOS-PS,HOOS-JR,VR-12).
- 使用分发和基方法计算的MCID和PASS值.
主要成果:
- 在第一个THA后观察到略低的基线PROM和略大改善,但差异并不具有临床意义.
- 对于第一个和第二个THA,发现了达到MCID和PASS值的相似率,尽管很大一部分患者没有达到PASS.
- 医疗保健的利用率,包括出院的安排和停留时间,显示出微小的差异,90天再入院率没有显著变化.
结论:
- 进行>1年间隔的对应THA产生了类似的临床结果和医疗保健利用.
- 虽然MCID和PASS的效果相似,但很少有患者在两种手术后报告疼痛缓解不足.
- 研究结果支持为患者提供相似的阶段性THA结果的咨询,强调需要对持续不充分的疼痛缓解进行进一步研究.
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