Using Patient-Reported Outcomes to Predict Revision Arthroplasty Following Femoral Neck Fracture: Enhancing the Value of Clinical Registries through Data Linkage

Christina L Ekegren, Richard de Steiger, Elton R Edwards, Richard S Page, Raphael Hau, Susan Liew, Andrew Oppy and Belinda J Gabbe
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Christina L Ekegren: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
Richard de Steiger: Epworth Hospital, Richmond, VIC 3121, Australia
Elton R Edwards: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
Richard S Page: Department of Orthopaedics, University Hospital Geelong, Geelong, VIC 3220, Australia
Raphael Hau: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
Susan Liew: Department of Orthopaedic Surgery, Alfred Hospital, Melbourne, VIC 3004, Australia
Andrew Oppy: Epworth Hospital, Richmond, VIC 3121, Australia
Belinda J Gabbe: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia

IJERPH, 2019, vol. 16, issue 8, 1-12

Abstract: The aim of this study was to determine the association between patient-reported outcome measures (PROMs) six months following femoral neck fracture after a low fall and future arthroplasty, and the factors associated with this. Six-month post-fracture PROMs were collected from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) for patients aged >55 years who were admitted for a femoral neck fracture after a low fall between March 2007 and June 2015. These cases were linked with those registered by Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) up to October 2016. Multivariable analysis was performed using a Cox proportional hazards model to determine factors associated with future arthroplasty, including six-month PROMs. Of the 7077 hip fracture patients registered by VOTOR during the study period, 2325 met the inclusion criteria. Internal fixation being used for the initial hip fracture surgery, being younger and having no pre-injury disability were all independently associated with future revision or conversion to arthroplasty. Out of all PROMs, reporting pain and discomfort six months post-fracture was associated with a 9.5-fold increase in the risk of future arthroplasty (95% CI: 3.81, 23.67). The value of clinical registries can be enhanced via data linkage, in this case by using PROMs to predict arthroplasty following femoral neck fracture.

Keywords: registries; patient reported outcome measures; femoral neck fractures; arthroplasty; pain (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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