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Table 4 Factors associated with change in WOMAC at 10 years exceeding the minimal clinically important difference

From: Long-term health related quality of life in total knee arthroplasty

Factors

Change in WOMAC exceeding MCID*

 

Pain

Stiffness

Function

 

Odds ratio**

(95% CI)

p

value

Odds ratio

(95% CI)

p

value

Odds ratio (95% CI)

p

value

Age (as continuous)

1 (0.97–1.04)

0.849

0.99 (0.96–1.03)

0.608

0.95 (0.92–0.98)

0.003

Age categorized

      

 ≤ 65

-ref-

-ref-

-ref-

-ref-

-ref-

-ref-

 65–75

1.06 (0.62–1.80)

0.842

1.20 (0.68–2.11)

0.525

0.77 (0.47–1.28)

0.318

 ≥ 75

1.82 (0.92–3.64)

0.088

1.28 (0.62–2.63)

0.500

0.60 (0.31–1.15)

0.125

Gender

      

 Female

-ref-

-ref-

-ref-

-ref-

-ref-

-ref-

 Male

1.06 (0.66–1.71)

0.810

0.82 (0.48–1.38)

0.446

1.60 (1-2.54)

0.048

BMI (as continuous)

0.93 (0.88–0.98)

0.004

0.93 (0.88–0.98)

0.009

0.93 (0.89–0.98)

0.006

BMI categorized

      

 BMI < 25

-ref-

-ref-

-ref-

-ref-

-ref-

-ref-

 25 ≤ BMI < 30

0.61 (0.25–1.47)

0.271

0.48 (0.20–1.14)

0.098

0.59 (0.27–1.28)

0.184

 30 ≤ BMI < 35

0.35 (0.14–0.86)

0.022

0.40 (0.17–0.95)

0.038

0.46 (0.21–1.02)

0.055

 BMI ≥ 35

0.39 (0.14–1.06)

0.065

0.29 (0.11–0.81)

0.018

0.27 (0.11–0.69)

0.006

Social support

1.17 (0.61–2.25)

0.631

1.67 (0.81–3.42)

0.164

1.08 (0.57–2.06)

0.809

Civil status categorized

      

 Married or Partner

0.60 (0.38–0.95)

0.028

0.70 (0.43–1.12)

0.134

1.17 (0.75–1.80)

0.492

 Divorced, widowed or single

-ref-

-ref-

-ref-

-ref-

-ref-

-ref-

Comorbidity

      

 Myocardial infarction

0.87 (0.28–2.76)

0.817

0.39 (0.10–1.59)

0.189

1.09 (0.34–3.49)

0.890

 Congestive heart disease

0.84 (0.27–2.67)

0.767

1.83 (0.53–6.26)

0.337

1.64 (0.56–4.78)

0.365

 Hypertension

0.67 (0.44–1.02)

0.062

0.89 (0.57–1.40)

0.613

0.63 (0.42–0.95)

0.028

 Peripheral vascular disease

0.68 (0.37–1.24)

0.208

0.70 (0.36–1.34)

0.277

0.47 (0.25–0.88)

0.017

 Chronic pulmonary disease

0.95 (0.44–2.05)

0.896

0.96 (0.42–2.20)

0.931

1.30 (0.63–2.68)

0.478

 Ulcer disease

0.64 (0.22–1.88)

0.418

0.39 (0.12–1.31)

0.127

0.68 (0.24–1.95)

0.469

 Diabetes

0.76 (0.39–1.46)

0.404

0.60 (0.29–1.24)

0.166

0.72 (0.38–1.37)

0.317

 Cancer Tumour

0.64 (0.11–3.65)

0.619

0.46 (0.05–4.69)

0.514

1.48 (0.26–8.38)

0.658

 Cerebrovascular disease

0.81 (0.24–2.74)

0.729

0.49 (0.13–1.80)

0.282

0.44 (0.11–1.73)

0.240

 Back pain (backache)

0.74 (0.37–1.47)

0.393

0.80 (0.38–1.70)

0.562

0.79 (0.40–1.55)

0.490

 Rheumatologic disease

0.40 (0.19–0.84)

0.015

0.88 (0.40–1.93)

0.742

0.63 (0.30–1.34)

0.230

 Depression

0.50 (0.23–1.09)

0.081

0.32 (0.13–0.75)

0.009

0.15 (0.06–0.40)

< 0.001

Other pathologies

      

 Back

1 (0.57–1.75)

0.992

1.15 (0.63–2.08)

0.647

0.82 (0.48–1.40)

0.460

 Homolateral hip

0.62 (0.20–1.89)

0.402

0.28 (0.08-1)

0.050

0.53 (0.17–1.60)

0.259

 Contraletral hip

1.01 (0.39–2.60)

0.982

0.44 (0.15–1.25)

0.122

0.68 (0.27–1.76)

0.427

 Contralateral knee

0.87 (0.56–1.35)

0.535

0.70 (0.44–1.12)

0.134

1.05 (0.69–1.60)

0.833

 Upper limbs

0.91 (0.33–2.51)

0.859

1 (0.33–3.04)

0.995

1.29 (0.49–3.40)

0.606

OA severity (Ahlbäck scale)

      

 Mild or moderate

-ref-

-ref-

-ref-

-ref-

-ref-

-ref-

 Severe

1.22 (0.70–2.14)

0.485

1.84 (0.97–3.50)

0.062

2.53 (1.35–4.73)

0.004

Days in hospital

0.98 (0.92–1.03)

0.419

0.96 (0.90–1.03)

0.252

0.96 (0.91–1.02)

0.186

Postoperative complications

1.31 (0.70–2.46)

0.404

1.98 (0.99–3.95)

0.054

1.50 (0.82–2.73)

0.189

Readmissions (6 months)

0.54 (0.30–0.98)

0.042

0.58 (0.30–1.11)

0.101

0.60 (0.32–1.12)

0.110

Complications from hospital discharge

0.35 (0.16–0.76)

0.007

0.25 (0.11–0.59)

0.002

0.51 (0.23–1.12)

0.093

Rehabilitation from hospital discharge

1.38 (0.86–2.22)

0.181

1.64 (0.99–2.73)

0.057

1.37 (0.87–2.16)

0.174

Reintervention during the follow-up

0.56 (0.28–1.11)

0.095

0.49 (0.23–1.04)

0.062

0.35 (0.16–0.79)

0.011

  1. Abbreviations: WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index (0, best; 100, worst); BMI = Body Mass Index; OA = Osteoarthritis; CI, Confidence interval; MCID, Minimal clinically important difference; ref: reference group
  2. This logistic regression models have been adjusted for the corresponding WOMAC baseline scores
  3. *Changes in WOMAC exceeding the cut-offs points of the MCID (Pain = 29.88; Stiffness = 26.76; Function = 32.72)
  4. **An Odds ratio < 1 indicates a lower likelihood of exceeding minimal clinically important difference; an Odds ratio > 1 indicates a higher likelihood of exceeding minimal clinically important difference