Patient Factors That Matter in Predicting Hip Arthroplasty Outcomes: A Machine-Learning Approach.
J Arthroplasty
; 36(6): 2024-2032, 2021 06.
Article
en En
| MEDLINE
| ID: mdl-33558044
ABSTRACT
BACKGROUND:
Despite the success of total hip arthroplasty (THA), approximately 10%-15% of patients will be dissatisfied with their outcome. Identifying patients at risk of not achieving meaningful gains postoperatively is critical to pre-surgical counseling and clinical decision support. Machine learning has shown promise in creating predictive models. This study used a machine-learning model to identify patient-specific variables that predict the postoperative functional outcome in THA.METHODS:
A prospective longitudinal cohort of 160 consecutive patients undergoing total hip replacement for the treatment of degenerative arthritis completed self-reported measures preoperatively and at 3 months postoperatively. Using four types of independent variables (patient demographics, patient-reported health, cognitive appraisal processes and surgical approach), a machine-learning model utilizing Least Absolute Shrinkage Selection Operator (LASSO) was constructed to predict postoperative Hip Disability and Osteoarthritis Outcome Score (HOOS) at 3 months.RESULTS:
The most predictive independent variables of postoperative HOOS were cognitive appraisal processes. Variables that predicted a worse HOOS consisted of frequent thoughts of work (ß = -0.34), frequent comparison to healthier peers (ß = -0.26), increased body mass index (ß = -0.17), increased medical comorbidities (ß = -0.19), and the anterior surgical approach (ß = -0.15). Variables that predicted a better HOOS consisted of employment at the time of surgery (ß = 0.17), and thoughts related to family interaction (ß = 0.12), trying not to complain (ß = 0.13), and helping others (ß = 0.22).CONCLUSIONS:
This clinical prediction model in THA revealed that the factors most predictive of outcome were cognitive appraisal processes, demonstrating their importance to outcome-based research. LEVEL OF EVIDENCE Prognostic Level 1.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Osteoartritis de la Cadera
/
Artroplastia de Reemplazo de Cadera
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Límite:
Humans
Idioma:
En
Revista:
J Arthroplasty
Asunto de la revista:
ORTOPEDIA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Canadá