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Multicenter Study
. 2024 Dec 4;25(1):992.
doi: 10.1186/s12891-024-08099-1.

Understanding preoperative health-related quality of life in rotator cuff tear patients: role of patients' characteristics

Daniela Brune  1   2 , Thomas Stojanov  3   4   5 , Andreas Marc Müller  4 , David Weibel  6   7 , Sabina Hunziker  8 , Stephanie Erdbrink  9 ; ARCR_Pred Study Group; Laurent Audigé  3   4   10
Collaborators, Affiliations
Multicenter Study

Understanding preoperative health-related quality of life in rotator cuff tear patients: role of patients' characteristics

Daniela Brune et al. BMC Musculoskelet Disord. .

Abstract

Background: Assessing health-related quality of life (HRQoL) is a widely employed method in orthopedics to evaluate patient well-being and measure the effectiveness of surgical interventions. Understanding the relationship between specific baseline factors and preoperative HRQoL can help clinicians identify patients at risk for low quality of life and thus, develop preventive strategies that adequately address individual patient needs. The objective was to assess associations between baseline factors and preoperative HRQoL in patients undergoing arthroscopic rotator cuff repair (ARCR).

Methods: This study is part of a multicenter prospective Swiss cohort study that included patients undergoing ARCR between June 2020 and November 2021. Data were derived from baseline and surgery forms. HRQoL was assessed using the European Quality of Life 5-Dimension 5-Level (EQ-5D-5L) questionnaire to calculate EQ-5D index and EQ VAS scores. Univariable and multivariable linear regression models examined associations between the 21 factors and preoperative HRQoL. Final models were determined using stepwise backward regression.

Results: A total of 973 included patients (mean age [SD], 57.3 [9.4] years; 611 men [63%]) had a mean [SD] EQ-5D index and EQ VAS of 0.70 [0.23] and 68.7 [19.8], respectively. Being male (regression coefficient (β), 0.05; 95% CI [0.02-0.08]), having a higher age (β, 0.02; 95% CI [0.01-0.03]) and higher education levels (e.g., university, college: β, 0.11; 95% CI [0.06-0.16]) were associated with a higher EQ-5D index. Increased body mass index (β, -0.02; 95% CI [-0.04 to -0.01]) and worse sleep quality (β, -0.03; 95% CI [-0.04 to -0.03]) were associated with a lower EQ-5D index. Factors negatively associated with overall EQ VAS health were depression (e.g., moderate: β, -12.70; 95% CI [-16.18 to -9.21]), presence of at least one comorbidity (β, -3.71; 95% CI [-5.91 to -1.52]), and pain (β, -1.81; 95% CI [-2.36 to -1.26]).

Conclusion: Our results suggest that preoperative HRQoL is highly associated with sociodemographic and patient-related factors. Specifically addressing these factors may improve orthopedic care.

Keywords: Arthroscopy; EQ-5D-5L; Health related quality of life; Shoulder.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This project was carried out in accordance with the protocol and principles enunciated in the current version of the Declaration of Helsinki and guidelines of Good Clinical Practice (GCP) issued by the International Council for Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) as well as Swiss law and Swiss regulatory authority requirements. Ethics approval was obtained on April 1st, 2020 from the lead ethics committee (Ethikkommission Nordwest- und Zentralschweiz (EKNZ), Basel, Switzerland; ID: 2019-02076) followed by subsequent amendments until December 20th, 2022, associated with the implementation of additional MRI examinations. All participants provided informed written consent before study enrollment . Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Distribution of EuroQoL-5 Dimensions-5-Level questionnaire (EQ-5D-5L) responses per dimension
Fig. 2
Fig. 2
Distribution of baseline EQ-5D index value and EQ VAS scores. Index score was multiplied by 100 for better visualization
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