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Ethnicity and patient's perception of risk in joint replacement surgery.

Gandhi R, Razak F, Davey JR, Mahomed NN.

Division of Orthopedic Surgery, University of Toronto, Toronto, Ontario, Canada. rajiv.gandhi@uhn.on.ca

OBJECTIVE: Despite much evidence showing racial disparities in the use of surgical procedures, it is unknown whether ethnicity affects perception of surgical risk. METHODS: We surveyed 1609 patients undergoing primary hip or knee replacement surgery. Relevant covariates including demographic data, body mass index (BMI), sex, comorbidities, education, and ethnicity were recorded. Pain and joint functional status were assessed at baseline and at 1-year followup with the Western Ontario McMaster University Osteoarthritis Index (WOMAC) pain and function scores. Risk perception was assessed with 3 survey questions. RESULTS: Non-European patients had greater functional disability and pain prior to surgery and demonstrated significantly greater perception of risk than European patients (p < 0.001). Independent of other covariates, non-European ethnicity was an independent predictor of a greater perception of risk (p < 0.05). CONCLUSION: Patient ethnicity is an important factor to consider in understanding a patient's perception of risk in joint replacement surgery.

PMID: 18597402 [PubMed - in process]