Abstract
BackgroundAmerican Society of Anaesthesiologists (ASA) physical status classification system and its association with postoperative outcomes has been studied in different diseases. However, there is a paucity of studies on the relationship between ASA class and postoperative health-related quality of life (HRQoL) outcomes following total hip replacement (THR).The aim of this study was to assess the discriminative abilities of EQ-5D-3L value sets from Sweden, Germany, Denmark and the United Kingdom in relation to ASA classes and these value sets’ abilities to show the predictive performance of ASA classes on HRQoL among THR patients in Sweden.MethodsA longitudinal study was conducted using data of patients in the Swedish Hip Arthroplasty Register who underwent THR between 2008 and 2016. We included 69,290 pre- and 1-year postoperative records and 21,305 6-year postoperative records. The study examined three experience-based EQ-5D-3L value sets (the Swedish VAS and TTO and the German VAS) and five hypothetical value sets (TTO from Germany and VAS and TTO value sets from Denmark and the UK each). Using linear models, the abilities of the value sets to discriminate among ASA classes and to show the predictive performance of ASA classes on HRQoL score were assessed.ResultsAll value sets differentiated among ASA classes and showed the predictive effect of ASA classes on HRQoL. ASA classes were found to predict HRQoL consistently for all value sets investigated, with small variations in prediction error among the models.ConclusionASA classes of patients undergoing THR predicted HRQoL scores significantly and consistently, indicating their importance in tailoring care for patients.
Highlights
American Society of Anaesthesiologists (ASA) physical status classification system and its association with postoperative outcomes has been studied in different diseases
In the present study, we assessed the abilities of EQ-5D3L value sets from Sweden, Germany, Denmark, and the UK to differentiate across ASA classes and in showing whether ASA classes predict health-related quality of life (HRQoL)
In the present study, differences in HRQoL score across ASA classes was demonstrated by all the value sets employed
Summary
American Society of Anaesthesiologists (ASA) physical status classification system and its association with postoperative outcomes has been studied in different diseases. There is a paucity of studies on the relationship between ASA class and postoperative health-related quality of life (HRQoL) outcomes following total hip replacement (THR). The aim of this study was to assess the discriminative abilities of EQ-5D-3L value sets from Sweden, Germany, Denmark and the United Kingdom in relation to ASA classes and these value sets’ abilities to show the predictive performance of ASA classes on HRQoL among THR patients in Sweden. Total hip replacement (THR) has been described as “the operation of the century” due to its very good long-term outcome and impact on health-related quality of life (HRQoL) [1]. In studying the impact of interventions like THR, different HRQoL instruments are employed to capture patient-reported outcomes (PROs). Besides the description of health in five dimensions, mobility, self-care, usual activities, pain/discomfort and anxiety/ depression, different value sets are applied to produce a single EQ-5D index. Value sets are developed through studies using various methods (time trade-off, TTO, and visual analogue scale, VAS) and perspectives (experience-based and hypothetical) [4,5,6,7,8,9] and are typically based on representative national population samples
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