PATIENT-RELATED RISK-FACTORS THAT PREDICT POOR OUTCOME AFTER TOTAL HIP-REPLACEMENT

Objective. To identify factors associated with poor outcome after tota l hip replacement (THR) surgery. Data Sources. This article is the fir st to present results from the American Medical Group Association (AMG A) THR consortium. Study Design. The outcomes evaluated were pain and physical function. Eight patients risk factors were evaluated. These i ncluded the age, sex, race, and marital status, and education of the p atient; whether the patient had polyarticular disease or other comorbi d conditions; and the patient's preoperative pain and physical functio n score. Data Collection. 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 postoperative ly. Principal Findings. Of the patient risk factors studied, race, edu cation, number of comorbid conditions, and preoperative Health Status Questionnaire (HSQ) score were found to be associated with poor outcom e. These risk factors were found to have an effect on both pain and ph ysical function at six months postoperatively. Patients with higher pr eoperative 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 co uld expect at least a 6-point decrease in postoperative improvement.Co nclusions. Our study indicates that preoperative status is an importan t predictor of outcome for THR.