Age, gender, obesity, and depression are associated with patient-related pain and function outcome after revision total hip arthroplasty.

Singh JA, Lewallen D. Age, gender, obesity, and depression are associated with patient-related pain and function outcome after revision total hip arthroplasty. Clinical Rheumatology. 2009 Dec 1; 28(12):1419-30.

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Abstract:

To examine whether patient characteristics predict patient-reported pain and function 2- or 5-years after revision total hip arthroplasty (THA). In a prospective cohort of revision THA patients, we examined whether gender, age, body mass index (BMI), comorbidity (Deyo-Charlson index) and depression predicted moderate-severe hip pain, moderate-severe activity limitation ( > or = 3 activities), dependence on walking aids and use of pain medications, using multivariable regression analysis. Significant predictors of moderate-severe pain at 2- and 5-years were [odds ratio (95% confidence interval)]: female gender, 1.3 (1.0, 1.6) and 1.5 (1.1, 1.9) and age 61-70, 0.7 (0.5, 1.0) and 0.7 (0.5, 1.0; reference (ref), < or = 60 years). BMI, 30-34.9, 1.4 (1.0, 1.9; ref BMI < or = 25) and depression, 1.6 (1.0, 2.5) were significantly associated with higher odds of moderate-severe pain at 2 years, but not at 5 years. Significant predictors of nonsteroidal anti-inflammatory drugs (NSAIDs) use 2-years post-revision THA were female gender, 1.4 (1.1, 1 .7), BMI, 30-34.9, 1.4 (1.0, 2.0) and age, 71-80, 0.7 (0.5, 0.9). At 5 years, female gender, 1.6 (1.2, 2.2) was significantly associated with NSAID use. Significant predictors of narcotic use 2-years post-revision THA were older age, 61-70, 0.5 (0.3, 0.7) and 71-80, 0.4 (0.3, 0.7) and depression, 2.4 (1.2, 4.6). At 5 years, women, had significantly higher odds 1.8 (1.1, 2.9) of narcotic use and those in age group 61-70 years, significantly lower odds of narcotic use, 0.4 (0.2, 0.7). Similarly, female gender, older age ( > 70) and BMI of 30 or higher were each significantly associated with higher odds of moderate-severe activity limitation at both, 2- and 5-years. Depression was associated with higher risk at 2 years, 1.7 (1.1, 2.6) and higher Deyo-Charlson score with a higher risk of moderate-severe activity limitation at 5 years, 1.7 (1.1, 2.7). Obesity and depression, considered modifiable clinical factors, were important independent predictors of pain, functional limitation and use of pain medications, following revision THA.