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Child-Pugh Class B or C Liver Disease Increases the Risk of Early Mortality in Patients With Hepatitis C Undergoing Elective Total Joint Arthroplasty Regardless of Treatment Status
CONCLUSION: Patients with HCV and a Child-Pugh Class B or C at the time of elective TJA had substantially increased odds of death, regardless of liver function, cirrhosis, age, Model for End-Stage Liver Disease level, HCV treatment, and viral load status. This is similar to the risk of early mortality observed in patients with chronic liver disease undergoing abdominal and cardiac surgery. Surgeons should avoid these major elective procedures in patients with Child-Pugh Class B or C whenever possible. For patients who feel their arthritic symptoms and pain are unbearable, surgeons need to be clear that the risk of death is...
Source: Clinical Orthopaedics and Related Research - March 24, 2023 Category: Orthopaedics Authors: Kyle H Cichos Eric Jordan Kian Niknam Antonia F Chen Erik N Hansen Gerald McGwin Elie S Ghanem Source Type: research

Effects of Patient Comorbidities and Demographics on Episode-of-Care Costs Following Total Shoulder Arthroplasty
CONCLUSION: Providers should be aware that certain demographic variables and comorbidities (history of stroke, dementia, chronic pulmonary disease, anemia, heart disease, advanced age, and elevated body mass index) are associated with an increase in total costs following primary shoulder arthroplasty. Further study is required to determine whether bundled payment target costs should be adjusted to better compensate for specific comorbidities.LEVEL OF EVIDENCE: Level IV case series.PMID:36749879 | DOI:10.5435/JAAOS-D-22-00450
Source: The Journal of the American Academy of Orthopaedic Surgeons - February 7, 2023 Category: Orthopaedics Authors: Dominic M Farronato Joshua D Pezzulo Alexander J Rondon Sean Porrini Diane McGonigal Charles L Getz Daniel E Davis Source Type: research

Characterizing Intraoperative Vasopressor Use in Total Knee Arthroplasty: A Retrospective Cohort Study
In conclusion, nearly 59% of patients undergoing TKA received intraoperative vasopressor support. History of stroke and older age were significantly associated with increased intraoperative vasopressor use. As the first study to examine vasopressor usage in a TKA patient population, we believe that understanding the association between patient characteristics and intraoperative vasopressor support will help orthopaedic surgeons select the appropriate surgical setting during preoperative optimization. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Ta...
Source: Journal of Knee Surgery - August 4, 2021 Category: Orthopaedics Authors: Lentine, Brandon Vaickus, Max Shewmaker, Grant Niu, Ruijia Son, Sung Jun Mustafa, Wissam Reist, Hailee Smith, Eric L. Tags: Original Article Source Type: research

Early Lessons on Bundled Payment at an Academic Medical Center.
CONCLUSION: Opportunities for savings under bundled payment may be greater for lower extremity joint arthroplasty than for other conditions. PMID: 28837458 [PubMed - in process]
Source: The Journal of the American Academy of Orthopaedic Surgeons - August 25, 2017 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Perioperative stroke in patients undergoing elective spinal surgery: a retrospective analysis using the Japanese diagnosis procedure combination database
Conclusions: Perioperative stroke occurred in 0.22 % of patients undergoing spinal surgery. Resection of a spinal cord tumor was associated with increased risk of perioperative stroke as well as advanced age, comorbidities at admission, cervical spine surgery, surgery in a teaching hospital, and length of stay.
Source: BMC Musculoskeletal Disorders - October 2, 2015 Category: Orthopaedics Authors: Junichi OhyaHirotaka ChikudaTakeshi OichiHiromasa HoriguchiKatsushi TakeshitaSakae TanakaHideo Yasunaga Source Type: research

Dedicated Orthopaedic Operating Rooms: Beneficial to Patients and Providers Alike
Objective: Dedicated orthopaedic operating rooms (DOORs) are increasingly popular solutions to reducing after-hours procedures, physician fatigue, and elective schedule disruptions. Although the benefits to surgeons are well understood, there are comparatively few studies that explore the effects of DOORs on patient care. We compared treatments and outcomes for all consecutive patients with femoral neck fractures, 4 years before and 4 years after implementation of a DOOR-based schedule. Design: Retrospective case–control study. Setting: Level 1 academic trauma center. Patients: A total of 111 consecutive trauma patients ...
Source: Journal of Orthopaedic Trauma - December 23, 2014 Category: Orthopaedics Tags: Original Article Source Type: research