Patient-related risk factors that predict poor outcome after total hip replacement.
OBJECTIVE
To identify factors associated with poor outcome after total hip replacement (THR) surgery.


METHODS
This article is the first to present results from the American Medical Group Association (AMGA) THR consortium.


METHODS
The outcomes evaluated were pain and physical function. Eight patient risk factors were evaluated. These included the age, sex, race, marital status, and education of the patient; whether the patient had polyarticular disease or other comorbid conditions; and the patient's preoperative pain and physical function score.


METHODS
Data were collected from patients using AMGA-approved, self-administered questionnaires preoperatively and at six weeks, three months, six months, one year, and two years postoperatively.


RESULTS
Of the patient risk factors studied, race, education, number of comorbid conditions, and preoperative Health Status Questionnaire (HSQ) score were found to be associated with poor outcome. These risk factors were found to have an effect on both pain and physical function at six months postoperatively. Patients with higher preoperative scores were found to have higher postoperative scores, but substantially fewer of these patients received any benefit from their surgery. For each 10-point increase in preoperative score, patients could expect at least a 6-point decrease in postoperative improvement.


CONCLUSIONS
Our study indicates that preoperative status is an important predictor of outcome for THR.
MacWilliam
C H
CH
Center for Clinical Effectiveness, Henry Ford Health System, Detroit, MI 48202-3450, USA.
Yood
M U
MU
Verner
J J
JJ
McCarthy
B D
BD
Ward
R E
RE
D000203:Activities of Daily Living; D000368:Aged; D015897:Comorbidity; D005260:Female; D006304:Health Status; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010149:Postoperative Pain / Q000209:etiology; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology