Health-related quality of life (EQ-5D) before and after orthopedic surgery

BACKGROUND AND PURPOSE: Population data on mortality and life expectancy are generally available for most countries. However, no longitudinal data based on the health-related quality of life outcome from the EQ-5D instrument have been reported for orthopedic patients. We assessed the effect of orthopedic surgery as measured by EQ-5D. METHODS: We analyzed EQ-5D data from 2,444 patients who were operated at the Department of Orthopedic Surgery at Karolinska University Hospital, 2001–2005. We also made a comparison between results from this cohort and those from a Swedish EQ-5D population survey. RESULTS: The mean EQ-5D (index) score improved from 0.54 to 0.72. Hip and knee arthroplasty, operations related to previous surgery, trauma-related procedures, and rheumatoid arthritis surgeries had preoperative EQ-5D (index) scores of 0.48 to 0.52. All of these groups showed substantial improvement in scores (0.63 to 0.80). Patients with tumors or diseases of the elbow/hand showed higher preoperative scores (0.66 to 0.77), which were similar postoperatively. In most patients, the EQ-5D (index) score improved but did not reach the level reported for an age- and sex-matched population sample (mean difference = 0.11). INTERPRETATION: Our results can be used as part of the preoperative patient information to increase the level of patient awareness and cooperation, and to facilitate rehabilitation. In future it will be possible—but not easy—to use the EQ-5D instrument as a complementary consideration in clinical priority assessment.