Analyzing the Burden of Revision Total Knee Arthroplasty in the United States between 2009 and 2016

J Knee Surg DOI: 10.1055/s-0041-1731324As the number of total knee arthroplasties (TKAs) increases, it is reasonable to expect the number of revision TKAs (rTKAs) to rise in parallel. The patient-related and societal burdens of rTKA are poorly understood. Therefore, the purpose of this study was to determine temporal changes in: (1) the incidence of rTKA; (2) patient and hospital characteristics; (3) complications, hospital lengths of stay (LOSs), and discharge dispositions; and (4) costs, charges, and payer types. All patients who underwent rTKA between 2009 and 2016 were identified from the National Inpatient Sample database using International Classification of Diseases, Ninth Revision and Tenth Revision codes and were studied. Univariate analyses were performed to compare the incidence of rTKA, patient and hospital characteristics, LOS and discharge dispositions, as well as costs, charges, and payer types. A multivariate logistic regression model was built to compare the odds of complications in 2009 and 2016. Over our study period, there was a 4.3% decrease in the incidence of rTKA. The mean age of patients who underwent rTKA was 65 years and a majority were female (58%). Mean hospital LOS decreased from 4.1 days in 2009 to 3.3 days in 2016 (p 
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research

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Authors: Gil JA, Goodman AD, Kleiner J, Walsh DF, Kosinski LR, Hsu R Abstract INTRODUCTION: The incidence of geriatric ankle fractures is rising. With the substantial variation in the physiologic and functional status within this age group, our null hypothesis was that mortality and complications of open reduction and internal fixation (ORIF) between patients who are aged 65 to 79 are equivalent to ORIF in patients who are aged 80 to 89. METHODS: Patients with ankle fracture were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes. Patients treate...
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research
Authors: Owens J, Otero JE, Noiseux NO, Springer BD, Martin JR Abstract Background: As the population ages, rate of total knee arthroplasty increases and thus, it is important to maximize efficiency and minimize risk. Identifying patients who are at higher risk for transfusion can help streamline care provided and minimize superfluous, costly hemoglobin monitoring in low risk patients. Methods: Adult patients who underwent total knee arthroplasty (TKA) in 2015 were identified in the National Surgical Quality Improvement Project (NSQIP) database. Patients were divided into two cohorts: those who required transfu...
Source: Iowa orthopaedic journal - Category: Orthopaedics Tags: Iowa Orthop J Source Type: research
CONCLUSIONS: The initiation of a new DNR status during hospitalization is associated with a significantly higher burden of both morbidity and mortality. This contrasts with prior studies that did not show an increased rate of adverse outcomes and suggests that a new DNR status in postoperative patients may reflect a consequence of adverse postoperative events. The informed consent process in older patients at risk for adverse outcomes after surgery should include discussions regarding goals of care and acceptable risk. PMID: 32718256 [PubMed - as supplied by publisher]
Source: Journal of Palliative Care - Category: Palliative Care Tags: J Palliat Care Source Type: research
Objective: To evaluate inpatient outcomes among patients with hip fracture treated during the COVID-19 pandemic in New York City. Design: Multicenter retrospective cohort study. Setting: One Level 1 trauma center and one orthopaedic specialty hospital in New York City. Patients/Participants: Fifty-nine consecutive patients (average age 85 years, range: 65–100 years) treated for a hip fracture (OTA/AO 31, 32.1) over a 5-week period, March 20, 2020, to April 24, 2020, during the height of the COVID-19 crisis. Main Outcome Measurements: COVID-19 infection status was used to stratify patients. The primary o...
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
J Knee Surg DOI: 10.1055/s-0040-1713128Given a national push toward bundled payment models, the purpose of this study was to examine the prevalence as well as the effect of smoking on early inpatient complications and cost following elective total knee arthroplasty (TKA) in the United States across multiple years. Using the nationwide inpatient sample, all primary elective TKA admissions were identified from 2012 to 2014. Patients were stratified by smoking status through a secondary diagnosis of “tobacco use disorder.” Patient characteristics as well as prevalence, costs, and incidence of complications were co...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
According to this study: A higher nursing skill mix (that is, one that includes more RNs) is associated with improvements in 12 patient outcomes.These 12 outcomes are length of stay; ulcer, gastritis, and upper gastrointestinal bleeds; acute myocardial infarction; restraint use; failure to rescue; pneumonia; sepsis; urinary tract infection; mortality/30-day mortality; pressure injury; infections (other than urinary tract infection); and shock, cardiac arrest, or heart failure.
Source: AJN - Category: Nursing Tags: Journal Watch Source Type: research
In conclusion, preoperative use of mammography was strongly associated with fewer perioperative complications and less in-hospital mortality after major surgeries. The evidence provided by this study justifies the implementation of preoperative health checks in clinical practice.
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
Publication date: Available online 2 November 2019Source: The Journal of Foot and Ankle SurgeryAuthor(s): Azeem Tariq Malik, Carmen E. Quatman, Safdar N. Khan, Laura S. Phieffer, Prakruti Rao, Thuan V. LyABSTRACTDespite increasing interest toward managing isolated ankle fractures in an outpatient setting, evidence of its safety remains largely limited. The 2007 to 2014 Humana Administrative Claims database was queried to identify patients undergoing open reduction internal fixation for unimalleolar, bimalleolar, or trimalleolar isolated closed ankle fractures. Two cohorts (outpatient versus inpatient) were then matched on ...
Source: The Journal of Foot and Ankle Surgery - Category: Orthopaedics Source Type: research
ConclusionsThe overall VTE rate after CABG has been low. However, the condition has been associated with worse 30-day postoperative outcomes and complications. The independent predictors of VTE development included a history of bleeding disorders, congestive heart failure in the 30 days before surgery, and operative time of ≥310 minutes. Understanding these risk factors should aid physicians in the decisions regarding prophylaxis and treatment.
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
J Knee Surg DOI: 10.1055/s-0039-1693450There is a paucity of literature comparing the relative merits of open arthrotomy versus arthroscopy for the surgical treatment of septic knee arthritis. The primary goal of this study is to compare the risk of perioperative complications between these two surgical techniques. To this end, 560 patients treated for septic arthritis of the native knee with arthroscopy were statistically matched 1:1 with 560 patients treated with open arthrotomy. The outcome measures included major complications, minor complications, mortality, inpatient hospital charges, and length of stay (LOS). Major ...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
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