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Co-Morbidities and Sex Differences in Long-Term Quality-of-Life Outcomes among Patients with and without Diabetes after Total Knee Replacement: Five-Year Data from Registry Study

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Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC 3053, Australia
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Department of Orthopaedics, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia
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Department of Surgery, The University of Melbourne, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia
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Health Economics Research Centre, Nuffield Department of Population Health, The University of Oxford, Oxford OX3 7LF, UK
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(1), 19; https://doi.org/10.3390/jcm9010019
Received: 20 November 2019 / Revised: 9 December 2019 / Accepted: 17 December 2019 / Published: 19 December 2019
(This article belongs to the Section Orthopedics)
Improved understanding of quality-of-life (QoL) outcomes can provide valuable information on intervention effectiveness and guide better patient care. The aim of this study was to examine whether QoL trajectories differ between patients with and without diabetes and identify to what extent patient characteristics are related to poor QoL outcomes after total joint replacement (TKR). Multilevel modelling was used to analyse long-term QoL patterns of patients undergoing TKR between 2006 and 2011. Patient-reported QoL at baseline and up to 5 years post-surgery were included. Of the 1553 TKR patients, one-fifth (n = 319) had diabetes. Despite there being no significant differences in QoL at baseline, patients with diabetes consistently reported lower QoL (on average by 0.028, p < 0.001) and did not improve to the same level as patients without the disease following surgery. Compared to males, females had significantly lower QoL (by 0.03, p < 0.001). Other baseline patient characteristics associated with important differences in QoL included presence of respiratory disease and mental health disorder. Patients with diabetes exhibit significantly poorer QoL compared to patients without diabetes, particularly among females. Knowledge of risk factors that impact on QoL can be useful for clinicians in identifying characteristics related to poor QoL outcomes and be used to guide patient-centered care. View Full-Text
Keywords: quality-of-life; joint surgery; sex differences; patient-reported outcomes; co-morbidities quality-of-life; joint surgery; sex differences; patient-reported outcomes; co-morbidities
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Tew, M.; Dowsey, M.M.; Choong, A.; Choong, P.F.; Clarke, P. Co-Morbidities and Sex Differences in Long-Term Quality-of-Life Outcomes among Patients with and without Diabetes after Total Knee Replacement: Five-Year Data from Registry Study. J. Clin. Med. 2020, 9, 19.

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