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Comparative Study
. 2013 Nov 6:14:316.
doi: 10.1186/1471-2474-14-316.

Factors influencing health-related quality of life after total hip replacement--a comparison of data from the Swedish and Danish hip arthroplasty registers

Max Gordon, Aksel Paulsen, Søren Overgaard, Göran Garellick, Alma B Pedersen, Ola Rolfson  1
Affiliations
Comparative Study

Factors influencing health-related quality of life after total hip replacement--a comparison of data from the Swedish and Danish hip arthroplasty registers

Max Gordon et al. BMC Musculoskelet Disord. .

Abstract

Background: There is an increasing focus on measuring patient-reported outcomes (PROs) as part of routine medical practice, particularly in fields such as joint replacement surgery where pain relief and improvement in health-related quality of life (HRQoL) are primary outcomes. Between-country comparisons of PROs may present difficulties due to cultural differences and differences in the provision of health care. However, in order to understand how these differences affect PROs, common predictors for poor and good outcomes need to be investigated. This cross-sectional study investigates factors influencing health-related quality of life (HRQoL) one year after total hip replacement (THR) surgery in Sweden and in Denmark.

Methods: Data was retrieved from the Swedish (n = 14,560 patients) and Danish (n = 632 patients) Hip Arthroplasty Registers according to preset selection criteria. Using linear regression models, we examined how sex, age, comorbidity and country of surgery were associated with different aspects of HRQoL as measured by the EQ-5D index and EQ VAS.

Results: Danish patients had an overall higher EQ-5D index and EQ VAS than Swedish patients (p < 0.001). After regression analysis, the estimated coefficients for sex, age, or the Charlson score did not differ between countries for either the EQ-5D index (p = 0.83) or EQ VAS (p = 0.41) one year after THR.

Conclusions: We conclude that there are clear similarities in how basic predictors influence patient-reported outcomes (PROs) in patients with THR in Sweden and Denmark and these known predictors of good or poor HRQoL outcomes are not specific for each country.

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Figures

Figure 1
Figure 1
Comparison of factors influencing EQ-5D index between Swedish and Danish patients. Forest plot with 95% confidence intervals for the estimates of EQ-5D index one year after THR for gender (reference=female), age 85 years (reference=65 years), and medium or high Charlson (reference=low Charlson) for Swedish (blue) and Danish (red) patients.
Figure 2
Figure 2
Comparison of factors influencing EQ VAS between Swedish and Danish patients. Forest plot with 95% confidence intervals for the estimates of EQ VAS one year after THR for gender (reference=female), age 85 years (reference=65 years), and medium or high Charlson (reference=low Charlson) for Swedish (blue) and Danish (red) patients.
Figure 3
Figure 3
The age as a spline for EQ-5D index. The spline is adjusted for sex = female, Charlson score = low, and country = Sweden.
Figure 4
Figure 4
The age as a spline for EQ VAS. The spline is adjusted for sex = female, Charlson score = low, and country = Sweden.
See this image and copyright information in PMC

Comment in

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