Can patient-reported outcomes predict re-operations after total hip replacement?

Int Orthop. 2018 Feb;42(2):273-279. doi: 10.1007/s00264-017-3711-z. Epub 2018 Jan 3.

Abstract

Purpose: We investigated if patient-reported outcomes (PROMs) one year after total hip replacement (THR) can predict the risk of re-operation using data from the Swedish Hip Arthroplasty Register.

Methods: A total of 75,899 patients with THR due to osteoarthritis operated in 2002-2014 were included. We used Kaplan-Meier and Cox regression to investigate the relationship between one-year post-operative PROMs and risk of re-operation (all types of further hip surgery). The predictive power of the model and post-operative PROMs were evaluated by concordance index (C).

Results: Kaplan-Meier estimates for not being re-operated at eight years was 95.5% (95%CI; 95.3-95.8). Cox regression analyses showed that all PROMs, except for EQ-VAS, were associated with re-operation. The full model had a concordance index of 0.68. Satisfaction (C = 0.65) and pain (C = 0.65) in isolation had the highest predictive power.

Conclusions: Worse PROMs predicted higher risk of re-operation. Therefore, we believe PROMs may be helpful in identifying patients at risk for re-operation and timely address their problems.

Keywords: Patient-reported outcome measurements; Prediction; Re-operation; Total hip replacement.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Hip / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis, Hip / surgery*
  • Pain / surgery
  • Pain Measurement
  • Patient Reported Outcome Measures*
  • Patient Satisfaction / statistics & numerical data
  • Registries
  • Regression Analysis
  • Reoperation / statistics & numerical data*
  • Risk Assessment / methods*
  • Survival Analysis
  • Sweden
  • Treatment Outcome