Abstract
The median age for total hip arthroplasty (THA) is over 70 years with the corollary that many individuals have multiple multimorbidities. Despite the predicted improvement in quality of life, THA might be denied even to those with low levels of multimorbidity.ObjectiveTo evaluate how pre-existing levels of multimorbidity influence the likelihood and timing of THA.SettingLongitudinal record linkage study of a UK sample linking their primary care to their secondary care records.ParticipantsA total of 28 025 patients were included, based on the recording of the diagnosis of hip osteoarthritis in a national primary care register, Clinical Practice Research Datalink. Data were extracted from the database on background health and morbidity status using five different constructs: Charlson Comorbidity Index, Electronic Frailty Index and counts of chronic diseases (from list of 17), prescribed medications and number of primary care visits prior to recording of osteoarthritis.Outcome measuresThe record of having received a THA as recorded in the primary care record and the linked secondary care database: Hospital Episode Statistics.Results40% had THA: median follow 10 months (range 1–17 years). Increased multimorbidity was associated with a decreased likelihood of undergoing THA, irrespective of the method of assessing multimorbidity although the impact varied by approach.ConclusionMarkers of pre-existing ill health influence the decision for THA in the elderly with end-stage hip osteoarthritis, although these effects are modest for indices of multimorbidity other than eFI. There is evidence of this influence being present even in people with moderate decrements in their health, despite the balance of benefits to risk in these individuals being positive.
Funder
National Institute for Health Research (Research for Patient Benefit programme,
Reference20 articles.
1. NHS Digital . Provisional Quarterly patient reported outcome measures (PROMs) in England, 2017. Available: https://digital.nhs.uk/catalogue/PUB23060
2. National Joint Registry . National joint Registry for England, Wales. Northern Ireland and the Isle of man: 17th annual report, 2020. Available: https://reports.njrcentre.org.uk/downloads
3. The Academy of Medical Sciences . Multimorbidity: a priority for global health research, 2018. Available: https://acmedsci.ac.uk/file-download/82222577 [Accessed 4 Apr 2019].
4. Assessing Risks and Benefits of Invasive Cardiac Procedures in Patients with Advanced Multimorbidity
5. Factors influencing health-related quality of life after total hip replacement - a comparison of data from the Swedish and Danish hip arthroplasty registers
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