title: Age, gender, obesity, and depression are associated with patient-related pain and function outcome after revision total hip arthroplasty.
abstract: To examine whether patient characteristics predict patient-reported pain and function 2- or 5-years after revision total hip arthroplasty (THA). In a prospective cohort of revision THA patients, we examined whether gender, age, body mass index (BMI), comorbidity (Deyo-Charlson index) and depression predicted moderate-severe hip pain, moderate-severe activity limitation (> or = 3 activities), dependence on walking aids and use of pain medications, using multivariable regression analysis. Significant predictors of moderate-severe pain at 2- and 5-years were [odds ratio (95% confidence interval)]: female gender, 1.3 (1.0, 1.6) and 1.5 (1.1, 1.9) and age 61-70, 0.7 (0.5, 1.0) and 0.7 (0.5, 1.0; reference (ref), < or = 60 years). BMI, 30-34.9, 1.4 (1.0, 1.9; ref BMI < or = 25) and depression, 1.6 (1.0, 2.5) were significantly associated with higher odds of moderate-severe pain at 2 years, but not at 5 years. Significant predictors of nonsteroidal anti-inflammatory drugs (NSAIDs) use 2-years post-revision THA were female gender, 1.4 (1.1, 1 .7), BMI, 30-34.9, 1.4 (1.0, 2.0) and age, 71-80, 0.7 (0.5, 0.9). At 5 years, female gender, 1.6 (1.2, 2.2) was significantly associated with NSAID use. Significant predictors of narcotic use 2-years post-revision THA were older age, 61-70, 0.5 (0.3, 0.7) and 71-80, 0.4 (0.3, 0.7) and depression, 2.4 (1.2, 4.6). At 5 years, women, had significantly higher odds 1.8 (1.1, 2.9) of narcotic use and those in age group 61-70 years, significantly lower odds of narcotic use, 0.4 (0.2, 0.7). Similarly, female gender, older age (>70) and BMI of 30 or higher were each significantly associated with higher odds of moderate-severe activity limitation at both, 2- and 5-years. Depression was associated with higher risk at 2 years, 1.7 (1.1, 2.6) and higher Deyo-Charlson score with a higher risk of moderate-severe activity limitation at 5 years, 1.7 (1.1, 2.7). Obesity and depression, considered modifiable clinical factors, were important independent predictors of pain, functional limitation and use of pain medications, following revision THA.
authors.affiliation: Department of Health Sciences Research, Mayo Clinic School of Medicine, Rochester, MN, USA. Jasvinder.md@gmail.com
authors.forename: Jasvinder A
authors.initials: JA
authors.lastname: Singh
authors.forename: David
authors.initials: D
authors.lastname: Lewallen
mesh_terms: D000367:Age Factors; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000534:rehabilitation; D015992:Body Mass Index; D015331:Cohort Studies; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology*; D015207:Osteoarthritis, Hip / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D010149:Postoperative Pain / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D011183:Postoperative Complications; D011446:Prospective Studies; D020127:Recovery of Function; D012086:Reoperation; D012737:Sex Factors; D016896:Treatment Outcome