Preoperative Assessment of Functional Capacity May Inform Better Surgical Preparation
Researchers from Johns Hopkins Medicine report that a preoperative assessment of routine functional status may be a simple means to predict postoperative outcomes for patients with hip joint osteoarthritis who undergo hip replacement surgery. This information could be useful in tailoring preoperative interventions such as physical therapy to individual patients, to enhance their prospects for a successful outcome from surgery. First author Michael Raad, MD, a postdoctoral research fellow in the Department of Orthopaedic Surgery at the Johns Hopkins University School of Medicine, commented, “With an aging society, we see an increased number of people who need or are referred for hip replacement surgeries. However, without a better understanding of factors that influence outcomes after surgery, we may not be making the best treatment plans for our patients, and our study offers a simple tool to help inform treatment decisions.” The findings were published last month in the journal Orthopedics.
For the study, the database of the American College of Surgeons National Surgical Quality Improvement Program provided records of over 43,000 patients with a diagnosis of osteoarthritis and who underwent primary total hip arthroplasty between 2009 and 2013. Preoperative functional status, in dimensions including hygiene, eating, and dressing was categorized as either independent or dependent, and regression analysis was used to determine associations between surgical outcomes and functional status. Patients categorized as dependent functional status before surgery ware found to be at 2 to 3 times greater risk for major complications, to be more likely to experience nonroutine discharge, and have 19% longer hospital stays, compared to patients in the independent functional status cohort. The authors recommend additional studies to develop better and more uniform measures of functional status.
Read about the study.
The journal abstract may be read here.