Predictors of Activity Limitation and Dependence on Walking Aids After Primary Total Hip Arthroplasty

• Autores: Jasvinder A. Singh, David G. Lewallen
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 58, Nº. 12, 2010, págs. 2387-2393
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • OBJECTIVES: To study function outcomes and their predictors after primary total hip arthroplasty (THA).

    DESIGN: Prospective cohort study.

    SETTING: Mayo Clinic.

    PARTICIPANTS: All patients who underwent primary THA at the Mayo Clinic between 1993 and 2005 and were alive at the time of follow-up.

    MEASUREMENTS: Whether sex, age, body mass index (BMI), comorbidity, anxiety, and depression predict moderate to severe activity limitation (limitation in ?3 activities) and complete dependence on waling aids 2 and 5 years after primary THA was examined. Multivariable logistic regression adjusted for operative diagnosis, American Society of Anesthesiologists score, implant type, and distance from medical center.

    RESULTS: At 2 years, 30.3% of participants reported moderate to severe activity limitation; at 5 years, 35% of participants reported moderate to severe activity limitation. Significant predictors of moderate to severe activity limitations at 2-year follow-up were female sex (odds ratio (OR)=1.2, 95% confidence interval (CI)=1.1�1.4), aged 71 to 80 (OR=2.0, 95% CI=1.6�2.5), aged 80 and older (OR=4.5, 95% CI=3.4�6.0), depression (OR=2.1, 95% CI=1.6�2.7), and BMI greater than 30.0. At 5-year follow-up, significant predictors were aged 71 to 80 (OR=1.7, 95% CI=1.3�2.2), older than 80 (OR=4.3, 95% CI=2.8�6.6), depression (OR=2.3, 95% CI=1.6�3.4), and BMI greater than 30.0.Significant predictors of complete dependence on walking aids at 2 years were female sex (OR=2.0, 95% CI=1.4�2.7), aged 71 to 80 (OR=2.4, 95% CI=1.4�4.2), older than 80 (OR=11.4, 95% CI=6.0�21.9), higher Deyo-Charlson score (OR=1.5, 95% CI=(1.1�1.2) for 5-point increase, depression (OR=2.0, 95% CI=1.2�3.4), and BMI greater than 35.0. Each of these factors also significantly predicted complete dependence on walking at 5-year follow-up, with similar odds ratios, except that BMI of 30.0 to 34.9 was not significantly associated.

    CONCLUSION: Higher BMI, depression, older age, and female sex predict activity limitation and complete dependence on walking aids 2 and 5 years after primary THA.