Factors Associated With Preoperative Quality of Life in Patients With Rotator Cuff Injury

Abstract BACKGROUND Assessing health-related quality of life (HRQoL) is a widely employed method in orthopedics to evaluate patient well-being and measure the effectiveness of surgical interventions. Understanding the relationship between specific baseline factors and preoperative HRQoL can help clinicians identify patients at risk for low quality of life and thus, develop preventive strategies that adequately address individual patient needs. The objective was to assess associations between baseline factors and preoperative HRQoL in patients undergoing arthroscopic rotator cuff repair (ARCR). METHODS This study is part of a multicenter prospective Swiss cohort study that included patients undergoing ARCR between June 2020 and November 2021. Data were derived from baseline and surgery forms. We examined possible associations between 5 sociodemographic, 7 patient- and 9 injury-related factors and preoperative HRQoL. HRQoL was assessed using the European Quality of Life 5-Dimension 5-Level (EQ-5D-5L) questionnaire to calculate EQ-5D index and EQ VAS scores. We followed the conceptual model of HRQoL for variable selection. Univariable and multivariable linear regression models examined associations between the 21 factors and preoperative HRQoL. Final models were determined using stepwise backward regression. RESULTS A total of 973 included patients (mean age SD, 57.3 9.4 years; 611 men 63%) had a mean SD EQ-5D index and EQ VAS of 0.70 0.23 and 68.7 19.8, respectively. Being male (regression coefficient (β), 0.05; 95% CI 0.02–0.08), having a higher age (β, 0.02; 95% CI 0.01–0.03) and higher education levels (e.g., university, college: β, 0.11; 95% CI 0.06–0.16) were associated with a higher EQ-5D index. Increased body mass index (β, -0.02; 95% CI -0.04 to -0.01) and worse sleep quality (β, -0.03; 95% CI -0.04 to -0.03) were associated with a lower EQ-5D index. Factors negatively associated with overall EQ VAS health were depression (e.g., moderate: β, -12.70; 95% CI -16.18 to -9.21), presence of at least one comorbidity (β, -3.71; 95% CI -5.91 to -1.52), and pain (β, -1.81; 95% CI -2.36 to -1.26). CONCLUSION Our results suggest that preoperative HRQoL is highly associated with sociodemographic and patient-related factors. Specifically addressing these factors may improve orthopedic care.