Time Trends in Perioperative Characteristics and Health Outcomes in Hispanic Patients Undergoing Primary Total Knee Arthroplasty.
Hispanic
Latino
Outcomes
Time trends, risk factors
Total knee arthroplasty
Journal
Journal of racial and ethnic health disparities
ISSN: 2196-8837
Titre abrégé: J Racial Ethn Health Disparities
Pays: Switzerland
ID NLM: 101628476
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
received:
21
08
2020
accepted:
23
10
2020
revised:
22
10
2020
pubmed:
31
10
2020
medline:
1
2
2022
entrez:
30
10
2020
Statut:
ppublish
Résumé
This study analyzed the yearly trends in procedure utilization, comorbidity profiles, hospital length of stay (LOS), and 30-day outcomes in Hispanic/Latino patients undergoing primary total knee arthroplasty (TKA). Risk stratification for the development of postsurgical adverse events (AEs) was also investigated. The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) was queried for all Hispanic/Latino patients who underwent primary, elective TKA between 2011 and 2017. Thirty-day outcomes and risk factors were determined using multivariate models that controlled for baseline and perioperative differences. A total of 12,767 Hispanic/Latino patients were identified. Over the study period, the rate of TKA utilization increased by 108%. During the same time, there were significant reductions in the rates of COPD (1.9% vs. 2.9%, p = 0.015), anemia (18.0% vs. 23.5%, p < 0.001), dyspnea (2.9% vs. 4.0%, p = 0.006), and procedure length > 100 min (35.2% vs. 39.4%, p < 0.001). Postoperatively, there was a significant decrease in LOS > 2 days (41.3% vs. 75.6%, p < 0.001), but there was an increase in the rate of developing 30-day AEs (5.8% vs. 4.7%, p = 0.046). Independent risk factors for 30-day AEs included age > 65 years, male sex, chronic steroid use, ASA > 2, diabetes, bleeding disorder, chronic kidney disease, and procedure length > 100 min. While the recent trends in procedure utilization, comorbidity profiles, and LOS in Hispanic/Latino patients undergoing primary TKA are reassuring, these have not been accompanied with improved postoperative safety. Patients with bleeding disorders, chronic steroid use, and those admitted from facilities other than home appear to be at highest risk for developing 30-day AEs.
Identifiants
pubmed: 33124004
doi: 10.1007/s40615-020-00910-8
pii: 10.1007/s40615-020-00910-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1475-1481Informations de copyright
© 2020. W. Montague Cobb-NMA Health Institute.
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