全膝关节置换术患者不满意危险因素分析

Analysis of dissatisfaction factors in patients underwent total knee arthroplasty

目的分析全膝关节置换术(TKA)后患者不满意度的相关因素。方法通过电话、门诊及视频电话等方式随访2012年1月至2015年12月行全膝关节置换手术患者,纳入因骨关节炎、类风湿性关节炎、创伤性关节炎及无严重术后并发症者,排除翻修患者。共纳入537例患者,按主观满意度评分分为满意组和不满意组,采用单因素和多因素logistic回归分析全膝关节置换术患者不满意的影响因素,包括年龄、常用膝关节评分及术后不适感等。结果多因素Logistic回归分析结果表明≥70岁,西安大略和麦克马斯特大学(WOMAC)骨关节炎评分高(OR=13.128)以及术后不适感(OR=19.275)可增加TKA术后患者不满意度,较高特种外科医院(HSS)评分可减少TKA术后患者不满意度(OR=0.141)。结论年龄大于70岁的患者容易产生不满意情绪,降低术后不适感仍是控制不满意度的重要因素。

Objective To analyze the related factors of patients′dissatisfaction after total knee arthroplasty(TKA).Methods The patients who underwent TKA from January 2012 to December 2015 were followed up by telephone,outpatient clinic and video call,including the patients who suffered from osteoarthritis,rheumatoid arthritis,traumatic arthritis and no serious postoperative complications.The patients of revison surgery were exclued.A total of 537 patients were enrolled,they were divided into the satisfied group and the dissatisfied group according to the subjective satisfaction score.The single factor and multivariate logistic regressions were used to analyze the influencing factors(including age,regular knee scores and postoperative discomfort)of dissatisfaction in the patients with TKA.Results Multivariate logistic regression analysis showed that more than 70 years old,higher Western Ontario and McMaster Universities(WOMAC)osteoarthritis score(OR=13.128)and postoperative discomfort(OR=19.275)increased patient dissatisfaction after TKA,and higher Hospital for Special Surgery(HSS)score reduced dissatisfaction of the patients after TKA(OR=0.141).Conclusions The patients over 70 years old are prone to produce dissatisfaction.Reducing postoperative discomfort is still an important factor to control dissatisfaction.