Predicting dissatisfaction following total hip arthroplasty using a Bayesian model averaging approach: Results from the Australian Arthroplasty Clinical Outcomes Registry National (ACORN)
This study confirms the high rates of patient satisfaction following total hip arthroplasty (THA), with postoperative complications being the only determinant of dissatisfaction. Optimization of patients prior to surgery may further improve satisfaction rates after THA. Background Total hip arthropl...
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| Veröffentlicht in: | ANZ journal of surgery 2021-09, Vol.91 (9), p.1908-1913 |
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| container_title | ANZ journal of surgery |
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| creator | Van Meirhaeghe, Jan P. Alarkawi, Dunia Kowalik, Tom Du‐Moulin, Will Molnar, Robert Adie, Sam |
| description | This study confirms the high rates of patient satisfaction following total hip arthroplasty (THA), with postoperative complications being the only determinant of dissatisfaction. Optimization of patients prior to surgery may further improve satisfaction rates after THA.
Background
Total hip arthroplasty (THA) provides excellent pain relief and improved function in patients with painful arthritis. The aim of this study was to identify rates and predictors of dissatisfaction following THA.
Methods
Data were collected prospectively from the Australian Arthroplasty Clinical Outcomes Registry National (ACORN) database between 2014 and 2016 from 2096 patients who underwent THA. Data included baseline demographics, patient‐reported outcome measures (PROMs) and postoperative clinical outcomes. Patients were dichotomized into two groups based on their 6‐month response to the satisfaction question answered on a Likert scale. Eighteen predefined variables were analyzed. PROMs included full Oxford Hip Score, EQ‐5D, and patient satisfaction. A Bayesian model averaging approach was used to build the best predictive model for dissatisfaction. Multiple logistic regression techniques were applied to quantify the effect size of the best model.
Results
At 6 months following THA, 95.4% of patients (n = 2000) were satisfied with surgical outcome and 4.6% (n = 96) were dissatisfied. The only variable that was significantly associated with dissatisfaction after THA was “complications after discharge.” This result was consistent for both the complete and imputed dataset (odds ratio 4.78, 95% confidence interval 2.60–8.80, P |
| doi_str_mv | 10.1111/ans.17063 |
| format | Article |
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Background
Total hip arthroplasty (THA) provides excellent pain relief and improved function in patients with painful arthritis. The aim of this study was to identify rates and predictors of dissatisfaction following THA.
Methods
Data were collected prospectively from the Australian Arthroplasty Clinical Outcomes Registry National (ACORN) database between 2014 and 2016 from 2096 patients who underwent THA. Data included baseline demographics, patient‐reported outcome measures (PROMs) and postoperative clinical outcomes. Patients were dichotomized into two groups based on their 6‐month response to the satisfaction question answered on a Likert scale. Eighteen predefined variables were analyzed. PROMs included full Oxford Hip Score, EQ‐5D, and patient satisfaction. A Bayesian model averaging approach was used to build the best predictive model for dissatisfaction. Multiple logistic regression techniques were applied to quantify the effect size of the best model.
Results
At 6 months following THA, 95.4% of patients (n = 2000) were satisfied with surgical outcome and 4.6% (n = 96) were dissatisfied. The only variable that was significantly associated with dissatisfaction after THA was “complications after discharge.” This result was consistent for both the complete and imputed dataset (odds ratio 4.78, 95% confidence interval 2.60–8.80, P < 0.001 and odds ratio 3.8, 95% confidence interval 2.60–5.60, P < 0.001, respectively).
Conclusion
Our study confirms the high rates of patient satisfaction following THA, with postoperative complications being the only determinant of dissatisfaction. Optimization of patients prior to surgery, reducing postoperative complications, may further improve satisfaction rates after THA.</description><identifier>ISSN: 1445-1433</identifier><identifier>EISSN: 1445-2197</identifier><identifier>DOI: 10.1111/ans.17063</identifier><language>eng</language><publisher>Melbourne: John Wiley & Sons Australia, Ltd</publisher><subject>Arthritis ; Bayesian analysis ; Biomedical materials ; Clinical outcomes ; Complications ; Confidence intervals ; Demographics ; Demography ; dissatisfaction ; Hip ; Joint replacement surgery ; Joint surgery ; Optimization ; Orthopaedic implants ; Pain ; Patient satisfaction ; Patients ; patient‐reported outcome measure ; Prediction models ; satisfaction ; Statistical analysis ; Total hip arthroplasty</subject><ispartof>ANZ journal of surgery, 2021-09, Vol.91 (9), p.1908-1913</ispartof><rights>2021 Royal Australasian College of Surgeons.</rights><rights>2021 Royal Australasian College of Surgeons</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3303-d3f18cd05bc6e482c157d13a63dec937da802acb88eef4b18a71d289a05030533</citedby><cites>FETCH-LOGICAL-c3303-d3f18cd05bc6e482c157d13a63dec937da802acb88eef4b18a71d289a05030533</cites><orcidid>0000-0003-0780-4338 ; 0000-0003-1311-7577</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fans.17063$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fans.17063$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids></links><search><creatorcontrib>Van Meirhaeghe, Jan P.</creatorcontrib><creatorcontrib>Alarkawi, Dunia</creatorcontrib><creatorcontrib>Kowalik, Tom</creatorcontrib><creatorcontrib>Du‐Moulin, Will</creatorcontrib><creatorcontrib>Molnar, Robert</creatorcontrib><creatorcontrib>Adie, Sam</creatorcontrib><title>Predicting dissatisfaction following total hip arthroplasty using a Bayesian model averaging approach: Results from the Australian Arthroplasty Clinical Outcomes Registry National (ACORN)</title><title>ANZ journal of surgery</title><description>This study confirms the high rates of patient satisfaction following total hip arthroplasty (THA), with postoperative complications being the only determinant of dissatisfaction. Optimization of patients prior to surgery may further improve satisfaction rates after THA.
Background
Total hip arthroplasty (THA) provides excellent pain relief and improved function in patients with painful arthritis. The aim of this study was to identify rates and predictors of dissatisfaction following THA.
Methods
Data were collected prospectively from the Australian Arthroplasty Clinical Outcomes Registry National (ACORN) database between 2014 and 2016 from 2096 patients who underwent THA. Data included baseline demographics, patient‐reported outcome measures (PROMs) and postoperative clinical outcomes. Patients were dichotomized into two groups based on their 6‐month response to the satisfaction question answered on a Likert scale. Eighteen predefined variables were analyzed. PROMs included full Oxford Hip Score, EQ‐5D, and patient satisfaction. A Bayesian model averaging approach was used to build the best predictive model for dissatisfaction. Multiple logistic regression techniques were applied to quantify the effect size of the best model.
Results
At 6 months following THA, 95.4% of patients (n = 2000) were satisfied with surgical outcome and 4.6% (n = 96) were dissatisfied. The only variable that was significantly associated with dissatisfaction after THA was “complications after discharge.” This result was consistent for both the complete and imputed dataset (odds ratio 4.78, 95% confidence interval 2.60–8.80, P < 0.001 and odds ratio 3.8, 95% confidence interval 2.60–5.60, P < 0.001, respectively).
Conclusion
Our study confirms the high rates of patient satisfaction following THA, with postoperative complications being the only determinant of dissatisfaction. Optimization of patients prior to surgery, reducing postoperative complications, may further improve satisfaction rates after THA.</description><subject>Arthritis</subject><subject>Bayesian analysis</subject><subject>Biomedical materials</subject><subject>Clinical outcomes</subject><subject>Complications</subject><subject>Confidence intervals</subject><subject>Demographics</subject><subject>Demography</subject><subject>dissatisfaction</subject><subject>Hip</subject><subject>Joint replacement surgery</subject><subject>Joint surgery</subject><subject>Optimization</subject><subject>Orthopaedic implants</subject><subject>Pain</subject><subject>Patient satisfaction</subject><subject>Patients</subject><subject>patient‐reported outcome measure</subject><subject>Prediction models</subject><subject>satisfaction</subject><subject>Statistical analysis</subject><subject>Total hip arthroplasty</subject><issn>1445-1433</issn><issn>1445-2197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kc1O3DAUhSPUSlDKom9giQ0sBuw4zg-7MOqfhGYQ0HV0x3ZmjJw4-DqgPFtfrg7DokLCm2vrfOf6Xp0k-cboBYvnEnq8YAXN-UFyxLJMLFJWFZ_e7izj_DD5gvhIKcvzShwlf2-9VkYG02-JMogQDLYQ364nrbPWvcxKcAEs2ZmBgA877wYLGCYy4iwCuYZJo4GedE5pS-BZe9i-SsPgHcjdFbnTONqApPWuI2GnST1i8GBnV_1_z6U1vZHxt_UYpOs0RuvWRHYiK5jHitJZvVzfrc6_Jp9bsKhP3upx8ufH94flr8XN-ufvZX2zkJxTvlC8ZaVUVGxkrrMylUwUinHIudKy4oWCkqYgN2WpdZttWAkFU2lZARWUU8H5cXK27xuXeRo1hqYzKLW10Gs3YpMKkVaVoKKM6Ok79NGNPs48UwWjGU9ZGqnzPSW9Q_S6bQZvOvBTw2gzx9jEGJvXGCN7uWdfjNXTx2BTr-73jn-8YKKy</recordid><startdate>202109</startdate><enddate>202109</enddate><creator>Van Meirhaeghe, Jan P.</creator><creator>Alarkawi, Dunia</creator><creator>Kowalik, Tom</creator><creator>Du‐Moulin, Will</creator><creator>Molnar, Robert</creator><creator>Adie, Sam</creator><general>John Wiley & Sons Australia, Ltd</general><general>Blackwell Publishing Ltd</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0780-4338</orcidid><orcidid>https://orcid.org/0000-0003-1311-7577</orcidid></search><sort><creationdate>202109</creationdate><title>Predicting dissatisfaction following total hip arthroplasty using a Bayesian model averaging approach: Results from the Australian Arthroplasty Clinical Outcomes Registry National (ACORN)</title><author>Van Meirhaeghe, Jan P. ; Alarkawi, Dunia ; Kowalik, Tom ; Du‐Moulin, Will ; Molnar, Robert ; Adie, Sam</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3303-d3f18cd05bc6e482c157d13a63dec937da802acb88eef4b18a71d289a05030533</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Arthritis</topic><topic>Bayesian analysis</topic><topic>Biomedical materials</topic><topic>Clinical outcomes</topic><topic>Complications</topic><topic>Confidence intervals</topic><topic>Demographics</topic><topic>Demography</topic><topic>dissatisfaction</topic><topic>Hip</topic><topic>Joint replacement surgery</topic><topic>Joint surgery</topic><topic>Optimization</topic><topic>Orthopaedic implants</topic><topic>Pain</topic><topic>Patient satisfaction</topic><topic>Patients</topic><topic>patient‐reported outcome measure</topic><topic>Prediction models</topic><topic>satisfaction</topic><topic>Statistical analysis</topic><topic>Total hip arthroplasty</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Van Meirhaeghe, Jan P.</creatorcontrib><creatorcontrib>Alarkawi, Dunia</creatorcontrib><creatorcontrib>Kowalik, Tom</creatorcontrib><creatorcontrib>Du‐Moulin, Will</creatorcontrib><creatorcontrib>Molnar, Robert</creatorcontrib><creatorcontrib>Adie, Sam</creatorcontrib><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>ANZ journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Van Meirhaeghe, Jan P.</au><au>Alarkawi, Dunia</au><au>Kowalik, Tom</au><au>Du‐Moulin, Will</au><au>Molnar, Robert</au><au>Adie, Sam</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predicting dissatisfaction following total hip arthroplasty using a Bayesian model averaging approach: Results from the Australian Arthroplasty Clinical Outcomes Registry National (ACORN)</atitle><jtitle>ANZ journal of surgery</jtitle><date>2021-09</date><risdate>2021</risdate><volume>91</volume><issue>9</issue><spage>1908</spage><epage>1913</epage><pages>1908-1913</pages><issn>1445-1433</issn><eissn>1445-2197</eissn><abstract>This study confirms the high rates of patient satisfaction following total hip arthroplasty (THA), with postoperative complications being the only determinant of dissatisfaction. Optimization of patients prior to surgery may further improve satisfaction rates after THA.
Background
Total hip arthroplasty (THA) provides excellent pain relief and improved function in patients with painful arthritis. The aim of this study was to identify rates and predictors of dissatisfaction following THA.
Methods
Data were collected prospectively from the Australian Arthroplasty Clinical Outcomes Registry National (ACORN) database between 2014 and 2016 from 2096 patients who underwent THA. Data included baseline demographics, patient‐reported outcome measures (PROMs) and postoperative clinical outcomes. Patients were dichotomized into two groups based on their 6‐month response to the satisfaction question answered on a Likert scale. Eighteen predefined variables were analyzed. PROMs included full Oxford Hip Score, EQ‐5D, and patient satisfaction. A Bayesian model averaging approach was used to build the best predictive model for dissatisfaction. Multiple logistic regression techniques were applied to quantify the effect size of the best model.
Results
At 6 months following THA, 95.4% of patients (n = 2000) were satisfied with surgical outcome and 4.6% (n = 96) were dissatisfied. The only variable that was significantly associated with dissatisfaction after THA was “complications after discharge.” This result was consistent for both the complete and imputed dataset (odds ratio 4.78, 95% confidence interval 2.60–8.80, P < 0.001 and odds ratio 3.8, 95% confidence interval 2.60–5.60, P < 0.001, respectively).
Conclusion
Our study confirms the high rates of patient satisfaction following THA, with postoperative complications being the only determinant of dissatisfaction. Optimization of patients prior to surgery, reducing postoperative complications, may further improve satisfaction rates after THA.</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><doi>10.1111/ans.17063</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-0780-4338</orcidid><orcidid>https://orcid.org/0000-0003-1311-7577</orcidid></addata></record> |
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| source | Wiley-Blackwell Journals |
| subjects | Arthritis Bayesian analysis Biomedical materials Clinical outcomes Complications Confidence intervals Demographics Demography dissatisfaction Hip Joint replacement surgery Joint surgery Optimization Orthopaedic implants Pain Patient satisfaction Patients patient‐reported outcome measure Prediction models satisfaction Statistical analysis Total hip arthroplasty |
| title | Predicting dissatisfaction following total hip arthroplasty using a Bayesian model averaging approach: Results from the Australian Arthroplasty Clinical Outcomes Registry National (ACORN) |
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