社会经济地位对髋部骨折后患者报告的结果测量的影响——一项基于登记的观察性研究,研究对象是2014-2018年挪威髋部骨折登记的35206名患者。

IF 3.2 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Cato Kjaervik, Jan-Erik Gjertsen, Eva Stensland, Jan Abel Olsen, Christer Kjaervik, Odd Soereide
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引用次数: 0

摘要

背景:髋部骨折由于数量增加、死亡率高和对健康相关生活质量(HRQoL)的负面影响,是一个重要的公共卫生问题。社会经济地位(SEP)影响各种健康结果,但对髋部骨折后HRQoL和满意度的具体影响尚不清楚。本研究评估教育程度和家庭收入是否影响髋部骨折后患者报告的结果测量(PROMs),通过三种视觉模拟量表测量:EQ-VAS,疼痛- vas和满意度- vas。方法:这是一项全国性的回顾性队列研究,使用挪威髋部骨折登记和挪威统计局的相关数据。纳入2015年至2018年35206例髋部骨折患者术后4、12和36个月的PROMs评估。SEP数据包括家庭收入和教育水平。采用协方差分析来评价一般健康状况(EQ-VAS)、手术髋关节疼痛(pain -VAS)和对手术结果的满意度(satisfaction -VAS)的平均VAS评分差异。分析调整了年龄、性别、生命状况、认知障碍、治疗类型、教育程度或收入等不作为自变量的因素。结果:该研究包括23649名女性(67.2%)和11557名男性(32.8%),中位年龄83岁。在所有随访中,较低的教育程度与较差的EQ-VAS和Pain-VAS评分有关,并且在未调整和调整分析中,在12个月和36个月时与较低的满意度- vas有关。在所有随访中,收入水平最低的患者EQ-VAS显著降低,12个月时疼痛- vas显著降低,4个月时满意度显著降低。随访期间vas平均评分差异越来越大。在36个月时,最高和最低收入水平的平均EQ-VAS调整差值为- 2,51(-4.04 -0.99)。教育水平之间的差异甚至更有关联;-3.58(-5.19至-1.98)。中等教育程度和低教育程度与高教育程度的疼痛- vas平均差异分别为4.30(2.91 ~ 5.69)和5.58(4.08 ~ 7.08)。教育程度较低的患者在36个月随访时满意度- vas也有显著的负差异-4.06(-5.86至-2.26)。结论:低学历和低收入与髋部骨折后患者HRQoL和满意度差有显著相关。这些发现的临床相关性值得进一步研究。解决SEP差异应该是旨在改善术后预后的髋骨折护理策略的一部分。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The influence of socioeconomic position on patient-reported outcome measures following hip fractures - a register-based observational study on 35,206 patients from the Norwegian hip fracture register 2014-2018.

Background: Hip fractures are a significant public health concern due to increasing numbers, high mortality and negative impact on health-related quality of life (HRQoL). Socioeconomic position (SEP) affects various health outcomes, but the specific impact on HRQoL and satisfaction after hip fracture remains underexplored. This study assesses whether education and household income influence patient-reported outcome measures (PROMs) after hip fractures, measured by three visual analog scales: EQ-VAS, pain-VAS, and satisfaction-VAS.

Methods: This was a nationwide retrospective cohort study using linked data from the Norwegian Hip Fracture Register and Statistics Norway. PROMs assessed at 4, 12, and 36 months postoperatively in 35,206 hip fracture patients from 2015 to 2018 were included. The SEP data included household income and education levels. Covariance analyses were conducted to evaluate differences in mean VAS scores for general health (EQ-VAS), pain from the operated hip (Pain-VAS), and satisfaction with the result of the operation (Satisfaction-VAS). Analyses adjusted for age, sex, vital status, cognitive impairment, treatment type, and education or income when not used as independent variable.

Results: The study included 23,649 women (67.2%) and 11,557 men (32.8%) with median age 83 years. Lower education was linked to worse EQ-VAS and Pain-VAS scores at all follow-ups and to lower Satisfaction-VAS at 12 and 36 months in both unadjusted and adjusted analyses. Lowest level of income had significant lower EQ-VAS at all follow-ups, lower Pain-VAS at 12 months, and lower Satisfaction-VAS at 4 months. There were increasing differences in mean VAS-scores during follow-up. At 36 months the adjusted differences in mean EQ-VAS between highest and lowest level of income was - 2,51 (-4.04 -0.99). Differences across education levels were even stronger associated; -3.58 (-5.19 to -1.98). Mean differences in Pain-VAS between medium and low education compared to high were 4.30 (2.91 to 5.69) and 5.58 (4.08 to 7.08), respectively. Lower levels of education also had significant negative differences in Satisfaction-VAS at 36 months follow-up -4.06(-5.86 to -2.26).

Conclusions: Lower education and income were significantly associated with worse HRQoL and satisfaction after hip fracture. The clinical relevance of these findings warrants further investigation. Addressing SEP disparities should be integral to hip-fracture care strategies aiming to improve postoperative outcomes.

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来源期刊
CiteScore
7.30
自引率
2.80%
发文量
154
审稿时长
3-8 weeks
期刊介绍: Health and Quality of Life Outcomes is an open access, peer-reviewed, journal offering high quality articles, rapid publication and wide diffusion in the public domain. Health and Quality of Life Outcomes considers original manuscripts on the Health-Related Quality of Life (HRQOL) assessment for evaluation of medical and psychosocial interventions. It also considers approaches and studies on psychometric properties of HRQOL and patient reported outcome measures, including cultural validation of instruments if they provide information about the impact of interventions. The journal publishes study protocols and reviews summarising the present state of knowledge concerning a particular aspect of HRQOL and patient reported outcome measures. Reviews should generally follow systematic review methodology. Comments on articles and letters to the editor are welcome.
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