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

1
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
2
Epworth Hospital, Richmond, VIC 3121, Australia
3
Department of Surgery, University of Melbourne, Melbourne, VIC 3010, Australia
4
Department of Orthopaedic Surgery, Alfred Hospital, Melbourne, VIC 3004, Australia
5
Department of Orthopaedics, University Hospital Geelong, Geelong, VIC 3220, Australia
6
Barwon Centre for Orthopaedic Research and Education, School of Medicine, Deakin University, Geelong, VIC 3220, Australia
7
Department of Orthopaedic Surgery, Box Hill Hospital, Melbourne, VIC 3128, Australia
8
Department of Orthopaedics, Northern Hospital, Epping, VIC 3076, Australia
9
Department of Surgery, Monash University, Clayton, VIC 3800, Australia
10
Department of Orthopaedic Surgery, Royal Melbourne Hospital, Melbourne, VIC 3050, Australia
11
Health Data Research UK, Swansea University Medical School, Swansea SA2 8PP, UK
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(8), 1325; https://doi.org/10.3390/ijerph16081325
Received: 15 March 2019 / Revised: 4 April 2019 / Accepted: 5 April 2019 / Published: 12 April 2019
(This article belongs to the Section Health Care Sciences & Services)
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PDF [885 KB, uploaded 12 April 2019]
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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. View Full-Text
Keywords: registries; patient reported outcome measures; femoral neck fractures; arthroplasty; pain registries; patient reported outcome measures; femoral neck fractures; arthroplasty; pain
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MDPI and ACS Style

Ekegren, C.L.; de Steiger, R.; Edwards, E.R.; Page, R.S.; Hau, R.; Liew, S.; Oppy, A.; Gabbe, B.J. Using Patient-Reported Outcomes to Predict Revision Arthroplasty Following Femoral Neck Fracture: Enhancing the Value of Clinical Registries through Data Linkage. Int. J. Environ. Res. Public Health 2019, 16, 1325.

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