Smoking is associated with post-operative complications but smokers
often under-report the amount they smoke. Our objective was to determine
whether a urine dipstick test could be used as a substitute for
quantitative cotinine assays to determine smoking status in patients. Between September 2013 and July 2014 we conducted a prospective
cohort study in which 127 consecutive patients undergoing a planned
foot and ankle arthrodesis or osteotomy were included. Patients
self-reported their smoking status and were classified as: ‘never
smoked’ (61 patients), ‘ex-smoker’ (46 patients), or ‘current smoker’ (20
patients). Urine samples were analysed with cotinine assays and
cotinine dipstick tests.Aims
Patients and Methods
The Oxford hip and knee scores are used to measure the outcome after primary total hip and knee replacement. We propose a new layout for the instrument in which patients are always asked about both limbs. In addition, we have defined an alternative scoring method which accounts for missing data. Over a period of 4.5 years, 4086 (1423 patients) and 5708 (1458 patients) questionnaires were completed for hips and knees, respectively. The hip score had a pre-operative median of 70.8 (interquartile range (IQR) 58.3 to 81.2) decreasing to 20.8 (IQR 10.4 to 35.4) after one year. The knee score had a pre-operative median of 68.8 (IQR 56.2 to 79.2) decreasing to 29.2 (IQR 14.6 to 45.8). There was no further significant change in either score after one year. As a result of the data analysis, we suggest that the score percentiles can be used as a standard for auditing patients before and after operation.
