Risk factors associated with poor pain outcomes following primary knee replacement surgery: Analysis of data from the clinical practice research datalink, hospital episode statistics and patient reported outcomes as part of the STAR research programme.
<h4>Objective</h4>Identify risk factors for poor pain outcomes six months after primary knee replacement surgery.<h4>Methods</h4>Observational cohort study on patients receiving primary knee replacement from the UK Clinical Practice Research Datalink, Hospital Episode Statist...
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Public Library of Science (PLoS)
2021-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0261850&type=printable |
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| author | Hasan Raza Mohammad Rachael Gooberman-Hill Antonella Delmestri John Broomfield Rita Patel Joerg Huber Cesar Garriga Christopher Eccleston Rafael Pinedo-Villanueva Tamer T Malak Nigel Arden Andrew Price Vikki Wylde Tim J Peters Ashley W Blom Andrew Judge |
| author_facet | Hasan Raza Mohammad Rachael Gooberman-Hill Antonella Delmestri John Broomfield Rita Patel Joerg Huber Cesar Garriga Christopher Eccleston Rafael Pinedo-Villanueva Tamer T Malak Nigel Arden Andrew Price Vikki Wylde Tim J Peters Ashley W Blom Andrew Judge |
| author_sort | Hasan Raza Mohammad |
| collection | DOAJ |
| description | <h4>Objective</h4>Identify risk factors for poor pain outcomes six months after primary knee replacement surgery.<h4>Methods</h4>Observational cohort study on patients receiving primary knee replacement from the UK Clinical Practice Research Datalink, Hospital Episode Statistics and Patient Reported Outcomes. A wide range of variables routinely collected in primary and secondary care were identified as potential predictors of worsening or only minor improvement in pain, based on the Oxford Knee Score pain subscale. Results are presented as relative risk ratios and adjusted risk differences (ARD) by fitting a generalized linear model with a binomial error structure and log link function.<h4>Results</h4>Information was available for 4,750 patients from 2009 to 2016, with a mean age of 69, of whom 56.1% were female. 10.4% of patients had poor pain outcomes. The strongest effects were seen for pre-operative factors: mild knee pain symptoms at the time of surgery (ARD 18.2% (95% Confidence Interval 13.6, 22.8), smoking 12.0% (95% CI:7.3, 16.6), living in the most deprived areas 5.6% (95% CI:2.3, 9.0) and obesity class II 6.3% (95% CI:3.0, 9.7). Important risk factors with more moderate effects included a history of previous knee arthroscopy surgery 4.6% (95% CI:2.5, 6.6), and use of opioids 3.4% (95% CI:1.4, 5.3) within three months after surgery. Those patients with worsening pain state change had more complications by 3 months (11.8% among those in a worse pain state vs. 2.7% with the same pain state).<h4>Conclusions</h4>We quantified the relative importance of individual risk factors including mild pre-operative pain, smoking, deprivation, obesity and opioid use in terms of the absolute proportions of patients achieving poor pain outcomes. These findings will support development of interventions to reduce the numbers of patients who have poor pain outcomes. |
| format | Article |
| id | doaj-art-0c2bd5aa03794b7ba7bb6e10ab7a3295 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-0c2bd5aa03794b7ba7bb6e10ab7a32952025-01-18T05:31:04ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-011612e026185010.1371/journal.pone.0261850Risk factors associated with poor pain outcomes following primary knee replacement surgery: Analysis of data from the clinical practice research datalink, hospital episode statistics and patient reported outcomes as part of the STAR research programme.Hasan Raza MohammadRachael Gooberman-HillAntonella DelmestriJohn BroomfieldRita PatelJoerg HuberCesar GarrigaChristopher EcclestonRafael Pinedo-VillanuevaTamer T MalakNigel ArdenAndrew PriceVikki WyldeTim J PetersAshley W BlomAndrew Judge<h4>Objective</h4>Identify risk factors for poor pain outcomes six months after primary knee replacement surgery.<h4>Methods</h4>Observational cohort study on patients receiving primary knee replacement from the UK Clinical Practice Research Datalink, Hospital Episode Statistics and Patient Reported Outcomes. A wide range of variables routinely collected in primary and secondary care were identified as potential predictors of worsening or only minor improvement in pain, based on the Oxford Knee Score pain subscale. Results are presented as relative risk ratios and adjusted risk differences (ARD) by fitting a generalized linear model with a binomial error structure and log link function.<h4>Results</h4>Information was available for 4,750 patients from 2009 to 2016, with a mean age of 69, of whom 56.1% were female. 10.4% of patients had poor pain outcomes. The strongest effects were seen for pre-operative factors: mild knee pain symptoms at the time of surgery (ARD 18.2% (95% Confidence Interval 13.6, 22.8), smoking 12.0% (95% CI:7.3, 16.6), living in the most deprived areas 5.6% (95% CI:2.3, 9.0) and obesity class II 6.3% (95% CI:3.0, 9.7). Important risk factors with more moderate effects included a history of previous knee arthroscopy surgery 4.6% (95% CI:2.5, 6.6), and use of opioids 3.4% (95% CI:1.4, 5.3) within three months after surgery. Those patients with worsening pain state change had more complications by 3 months (11.8% among those in a worse pain state vs. 2.7% with the same pain state).<h4>Conclusions</h4>We quantified the relative importance of individual risk factors including mild pre-operative pain, smoking, deprivation, obesity and opioid use in terms of the absolute proportions of patients achieving poor pain outcomes. These findings will support development of interventions to reduce the numbers of patients who have poor pain outcomes.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0261850&type=printable |
| spellingShingle | Hasan Raza Mohammad Rachael Gooberman-Hill Antonella Delmestri John Broomfield Rita Patel Joerg Huber Cesar Garriga Christopher Eccleston Rafael Pinedo-Villanueva Tamer T Malak Nigel Arden Andrew Price Vikki Wylde Tim J Peters Ashley W Blom Andrew Judge Risk factors associated with poor pain outcomes following primary knee replacement surgery: Analysis of data from the clinical practice research datalink, hospital episode statistics and patient reported outcomes as part of the STAR research programme. PLoS ONE |
| title | Risk factors associated with poor pain outcomes following primary knee replacement surgery: Analysis of data from the clinical practice research datalink, hospital episode statistics and patient reported outcomes as part of the STAR research programme. |
| title_full | Risk factors associated with poor pain outcomes following primary knee replacement surgery: Analysis of data from the clinical practice research datalink, hospital episode statistics and patient reported outcomes as part of the STAR research programme. |
| title_fullStr | Risk factors associated with poor pain outcomes following primary knee replacement surgery: Analysis of data from the clinical practice research datalink, hospital episode statistics and patient reported outcomes as part of the STAR research programme. |
| title_full_unstemmed | Risk factors associated with poor pain outcomes following primary knee replacement surgery: Analysis of data from the clinical practice research datalink, hospital episode statistics and patient reported outcomes as part of the STAR research programme. |
| title_short | Risk factors associated with poor pain outcomes following primary knee replacement surgery: Analysis of data from the clinical practice research datalink, hospital episode statistics and patient reported outcomes as part of the STAR research programme. |
| title_sort | risk factors associated with poor pain outcomes following primary knee replacement surgery analysis of data from the clinical practice research datalink hospital episode statistics and patient reported outcomes as part of the star research programme |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0261850&type=printable |
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