Which patient factors influence pre-operative and post-operative completion of patient reported outcome surveys in total joint replacement surgery?

Background: Patient reported outcome measures have become a widely-used indicator of the quality of interventions in joint reconstruction. This study aimed to determine which patient variables affect completion of patient-reported outcome measurements. Methods: All patients undergoing total knee or total hip arthroplasty (TKA/THA) between January 1st, 2019 to August 31st, 2022 at a single institution were retrospectively reviewed. The Knee Injury and Osteoarthritis Outcome Score (KOOS) and The Hip Disability and Osteoarthritis Outcome Score (HOOS) was administered preoperatively and at 3, 6, 12, and 24 months post-operatively. Completion rates of baseline and subsequent HOOS/KOOS surveys were assessed to identify factors that contributed to PROM completion. Results: In the adjusted multivariable analysis, patients older than 60 years had higher preoperative PROMs compliance. TKA (OR 0.92 95 % CI [0.86, 0.98]) and an ASA score of 3 or 4 (OR 0.88 95 % CI [0.82, 0.95]) were associated with decreased compliance. Patients aged 60-74 years had higher PROMs compliance than those <60 years (3-months: OR 1.61, 95 % CI [1.40, 1.84]; 6-months: OR 1.70, 95 % CI [1.48, 1.96]; 1-year: OR 1.69, 95 % CI [1.51, 1.90]; 2-year: OR 1.70, 95 % CI [1.52, 1.90]). Additional factors were identified to be correlated with compliance rates at various follow-up time points. Age >60, sex, Length of stay, BMI, ASA score, and TKA vs. THA arthroplasty all influenced PROMs compliance. Conclusions: As PROMs are increasingly used a quality measurement, identification of variables that influence survey completion will help to address selection biases in these measurements.