What is the Impact of Social Deprivation on Mental and Physical Health Before and After Primary Total Knee Arthroplasty?
Background: The purpose of the present study was to investigate the relationship between socioeconomic status and Patient-Reported Outcomes Measurement Information System Global Health (PROMIS-GH) scores before and after primary total knee arthroplasty (TKA). We hypothesized that patients with great...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344123000614 |
| _version_ | 1827860206063714304 |
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| author | Morgan L. Gulley, MS Christopher N. Carender, MD Natalie A. Glass, PhD Nicholas A. Bedard, MD |
| author_facet | Morgan L. Gulley, MS Christopher N. Carender, MD Natalie A. Glass, PhD Nicholas A. Bedard, MD |
| author_sort | Morgan L. Gulley, MS |
| collection | DOAJ |
| description | Background: The purpose of the present study was to investigate the relationship between socioeconomic status and Patient-Reported Outcomes Measurement Information System Global Health (PROMIS-GH) scores before and after primary total knee arthroplasty (TKA). We hypothesized that patients with greater social deprivation would have lower PROMIS-GH scores at 3 months and 1 year following primary TKA. Methods: We retrospectively reviewed data from patients who underwent unilateral primary TKA and completed PROMIS-GH preoperatively and at 3 months (n = 257) or 1 year (n = 154) postoperatively. Area Deprivation Index (ADI), calculated from 9-digit zip codes, was used to measure social deprivation. Participants were grouped into quartiles by ADI score. Minimal clinically important difference in PROMIS-GH mental (PROMIS-MH) and physical health (PROMIS-PH) component scores were compared between ADI groups. Results: Participants in the highest ADI quartile (most disadvantaged) had significantly lower PROMIS-MH and PROMIS-PH scores at every time point relative to the lowest ADI quartile (least disadvantaged) (P < .05 for all). Both ADI groups experienced significant improvements in PROMIS-PH following TKA (P < .001 for all), but not in PROMIS-MH (P > .05 for all) at 3-months and 1-year postoperatively. Magnitude of improvement in PROMIS-PH and rates of achievement of minimal clinically important difference did not significantly differ between ADI groups (P > .05 for all). Conclusions: Socially disadvantaged patients benefit equally from primary TKA but are more likely to have persistently lower 1-year postoperative PROMIS-GH scores relative to less disadvantaged patients. Social deprivation should be accounted for when using PROMIS-GH to assess clinical outcomes for research and quality measures. Level of Evidence: IV, retrospective cohort study. |
| first_indexed | 2024-03-12T13:19:56Z |
| format | Article |
| id | doaj.art-f1dc7ad328e84c01aa146484ed162ba0 |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-03-12T13:19:56Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-f1dc7ad328e84c01aa146484ed162ba02023-08-26T04:43:32ZengElsevierArthroplasty Today2352-34412023-08-0122101156What is the Impact of Social Deprivation on Mental and Physical Health Before and After Primary Total Knee Arthroplasty?Morgan L. Gulley, MS0Christopher N. Carender, MD1Natalie A. Glass, PhD2Nicholas A. Bedard, MD3Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USADepartment of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USADepartment of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USADivision of Hip and Knee Reconstruction, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Corresponding author. Division of Hip and Knee Reconstruction, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. Tel.: +1 507 284 4896.Background: The purpose of the present study was to investigate the relationship between socioeconomic status and Patient-Reported Outcomes Measurement Information System Global Health (PROMIS-GH) scores before and after primary total knee arthroplasty (TKA). We hypothesized that patients with greater social deprivation would have lower PROMIS-GH scores at 3 months and 1 year following primary TKA. Methods: We retrospectively reviewed data from patients who underwent unilateral primary TKA and completed PROMIS-GH preoperatively and at 3 months (n = 257) or 1 year (n = 154) postoperatively. Area Deprivation Index (ADI), calculated from 9-digit zip codes, was used to measure social deprivation. Participants were grouped into quartiles by ADI score. Minimal clinically important difference in PROMIS-GH mental (PROMIS-MH) and physical health (PROMIS-PH) component scores were compared between ADI groups. Results: Participants in the highest ADI quartile (most disadvantaged) had significantly lower PROMIS-MH and PROMIS-PH scores at every time point relative to the lowest ADI quartile (least disadvantaged) (P < .05 for all). Both ADI groups experienced significant improvements in PROMIS-PH following TKA (P < .001 for all), but not in PROMIS-MH (P > .05 for all) at 3-months and 1-year postoperatively. Magnitude of improvement in PROMIS-PH and rates of achievement of minimal clinically important difference did not significantly differ between ADI groups (P > .05 for all). Conclusions: Socially disadvantaged patients benefit equally from primary TKA but are more likely to have persistently lower 1-year postoperative PROMIS-GH scores relative to less disadvantaged patients. Social deprivation should be accounted for when using PROMIS-GH to assess clinical outcomes for research and quality measures. Level of Evidence: IV, retrospective cohort study.http://www.sciencedirect.com/science/article/pii/S2352344123000614Social deprivationPROMISPatient-reported outcome measureTotal knee arthroplasty |
| spellingShingle | Morgan L. Gulley, MS Christopher N. Carender, MD Natalie A. Glass, PhD Nicholas A. Bedard, MD What is the Impact of Social Deprivation on Mental and Physical Health Before and After Primary Total Knee Arthroplasty? Arthroplasty Today Social deprivation PROMIS Patient-reported outcome measure Total knee arthroplasty |
| title | What is the Impact of Social Deprivation on Mental and Physical Health Before and After Primary Total Knee Arthroplasty? |
| title_full | What is the Impact of Social Deprivation on Mental and Physical Health Before and After Primary Total Knee Arthroplasty? |
| title_fullStr | What is the Impact of Social Deprivation on Mental and Physical Health Before and After Primary Total Knee Arthroplasty? |
| title_full_unstemmed | What is the Impact of Social Deprivation on Mental and Physical Health Before and After Primary Total Knee Arthroplasty? |
| title_short | What is the Impact of Social Deprivation on Mental and Physical Health Before and After Primary Total Knee Arthroplasty? |
| title_sort | what is the impact of social deprivation on mental and physical health before and after primary total knee arthroplasty |
| topic | Social deprivation PROMIS Patient-reported outcome measure Total knee arthroplasty |
| url | http://www.sciencedirect.com/science/article/pii/S2352344123000614 |
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