Biomedical subjects

Marianne Rigge

Publications and source records attributed to Marianne Rigge.

3 recordsLinked to original sources

PubMed2002

Mortality, morbidity, and 1-year outcomes of primary elective total hip arthroplasty.

No representative data exist on the risks of adverse outcomes of total hip arthroplasty (THA) in the United Kingdom. A prospective observational study of unselected THA operations was carried out in 5 U.K. regions. Adverse outcomes were assessed from the hospital case notes and general practitioners of 1,100 randomly selected patients and from 7,151 patient-completed questionnaires 3 and 12 months after THA. Three-month mortality was 0.4% to 0.7%. Dislocation and thromboembolic complications were about 3% and 4%. Perioperative fracture, sciatic nerve palsy, aseptic loosening, and revision each had a risk of < or = 1%. At 1 year, 2.6% of patients had undergone another operation on the same hip, 11% reported moderate or severe pain in the operated hip, 23% had severe walking restriction, and 11% were dissatisfied with the operation. Patients and surgeons in the United Kingdom should have access to this information when making a decision about THA.

Arthroplasty, Replacement, Hip↗

PubMed2002

Does waiting for total hip replacement matter? Prospective cohort study.

OBJECTIVES: To assess the impact on the outcome of total hip replacement of the length of timing spent waiting for surgery. METHODS: One hundred and forty-three orthopaedic and general hospitals provided information about aspects of surgical practice for each total hip replacement conducted between September 1996 and October 1997 for publicly and privately funded operations in five English health regions. These data were linked to patient information about hip-related pain and disability status (measured using the Oxford Hip Score) before operation and at 3 and 12 months after. Data were analysed using multiple regression analysis. RESULTS: Questionnaires were completed by surgeons for 10,410 (78%) patients treated during the recruitment period and by 7151 (54%) patients. Twelve months after total hip replacement, the majority of patients experienced substantial improvements in hip-related pain and disability (as measured by the Oxford Hip Score). Those patients who started with a worse Oxford Hip Score before the operation tended to remain worse after the operation. Worse pre-operative score was associated with an increased length of either outpatient or inpatient wait, and this trend remained after the operation. The relationship between waiting time and outcome remained after adjustment for possible confounding variables. A consistently worse score was observed in public compared with private patients at all three time-points. In addition, in both sectors, those patients who were socially disadvantaged had a worse score than more socially advantaged patients both before and after the operation. CONCLUSIONS: Waiting for surgery is associated with worse outcomes 12 months later. Longer-term outcome needs to be considered to see if this association persists.

Activities of Daily Living↗

PubMed2000

The use of patients' stories by self-help groups: a survey of voluntary organizations in the UK on the register of the College of Health.

OBJECTIVE: First-hand accounts of illness experience are believed to provide important insights for other patients and their carers. We report the results of a survey that explored how patients' stories are being collected and used by self-help and voluntary groups. METHODS: The annual College of Health survey contacts 2 458 addresses, which includes many self-help groups and voluntary associations. A brief questionnaire for the self-help groups on the register was attached to the summer 1999 survey on behalf of the DIPEx (database of individual patient experience) project. RESULTS: DIPEx received replies from 309 organizations representing a wide range of interests and conditions. These indicated that 202 (65%) of the groups currently use patients' stories in various ways. A further 59 (19%) of the groups reported that although they are not currently using them, they would like to in the future. Organizations that use patients' stories were invited to describe how they use them and provide examples, if applicable. Content analysis of the free text descriptions revealed 22 distinct uses among the 202 organizations using patient stories. The most frequent uses are the inclusion of patient stories in interviews or articles for the group newsletter (74 or 37%) and the use of stories for inclusion in newspaper articles or media broadcasts (31 or 15%). Some form of database of patients' stories was maintained by 23 groups (12%). CONCLUSIONS: These findings suggest that patients' stories are widely collected and used to support a wide range of the recognized functions of self-help and voluntary groups. This is encouraging to the DIPEx project's efforts to collect and analyse accounts of illness experience, which will be presented with evidence-based information about the effects of treatments.

Journal Article↗