Hospital volume-outcome relationship in total knee arthroplasty: a systematic review and dose-response meta-analysis.

Arthroplasty, Replacement, Knee / adverse effects Hospitals, High-Volume Humans Odds Ratio Prosthesis-Related Infections / epidemiology Randomized Controlled Trials as Topic Reoperation / statistics & numerical data Treatment Outcome
Dose–response meta-analysis Hospital volume Hospital volume–outcome relationship Knee osteoarthritis Systematic review Total knee arthroplasty (TKA)

Journal

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
ISSN: 1433-7347
Titre abrégé: Knee Surg Sports Traumatol Arthrosc
Pays: Germany
ID NLM: 9314730

Informations de publication

Date de publication:
Aug 2022
Historique:
received: 21 04 2021
accepted: 06 08 2021
pubmed: 9 9 2021
medline: 27 7 2022
entrez: 8 9 2021
Statut: ppublish

Résumé

This systematic review and dose-response meta-analysis aimed to investigate the relationship between hospital volume and outcomes for total knee arthroplasty (TKA). MEDLINE, Embase, CENTRAL and CINAHL were searched up to February 2020 for randomised controlled trials and cohort studies that reported TKA performed in hospitals with at least two different volumes and any associated patient-relevant outcomes. The adjusted effect estimates (odds ratios, OR) were pooled using a random-effects, linear dose-response meta-analysis. Heterogeneity was quantified using the I A total of 68 cohort studies with data from 1985 to 2018 were included. The risk of bias for all outcomes ranged from moderate to critical. Higher hospital volume may be associated with a lower rate of early revision ≤ 12 months (narrative synthesis of k = 7 studies, n = 301,378 patients) and is likely associated with lower mortality ≤ 3 months (OR = 0.91 per additional 50 TKAs/year, 95% confidence interval [0.87-0.95], k = 9, n = 2,638,996, I An inverse volume-outcome relationship probably exists for some TKA outcomes, including mortality and readmissions, and may exist for early revisions. Small reductions in unfavourable outcomes may be clinically relevant at the population level, supporting centralisation of TKA to high-volume hospitals. III. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42019131209 available at: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=131209 ).

Identifiants

DOI: 10.1007/s00167-021-06692-8 PMID: 34494124 PMC: PMC9309153
pubmed: 34494124
doi: 10.1007/s00167-021-06692-8
pii: 10.1007/s00167-021-06692-8
pmc: PMC9309153
doi:

Types de publication

Journal Article Meta-Analysis Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

2862-2877

Subventions

Organisme : Bundesministerium für Bildung und Forschung
ID : 01KG1805

Informations de copyright

© 2021. The Author(s).

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Auteurs

C M Kugler (CM)

Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany. charlotte.kugler@uni-wh.de.
ORCID: 0000-0003-4170-3290

K Goossen (K)

Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany.

T Rombey (T)

Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany.
Department of Health Care Management, Technische Universität Berlin, Straße des 17. Juni 135, 10623, Berlin, Germany.

K K De Santis (KK)

Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany.
Leibniz Institute for Prevention Research and Epidemiology (BIPS), Achterstr. 30, 28359, Bremen, Germany.

T Mathes (T)

Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany.

J Breuing (J)

Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany.

S Hess (S)

Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany.

R Burchard (R)

Department of Orthopaedics and Trauma Surgery, Lahn-Dill-Kliniken, Rotebergstr. 2, 35683, Dillenburg, Germany.
Department of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany.
Department of Orthopaedics and Traumatology, University of Giessen and Marburg, Baldingerstraße, 35032, Marburg, Germany.

D Pieper (D)

Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany.

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Classifications MeSH

questionsmedicales.fr › Procédures de chirurgie opératoire › Implantation de prothèse › Arthroplastie prothétique › Arthroplastie prothétique de genou › Hospital volume-outcome relationship in total...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Établissements de santé › Hôpitaux › Hôpitaux à haut volume d'activité › Hospital volume-outcome relationship in total...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Hospital volume-outcome relationship in total...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Odds ratio › Hospital volume-outcome relationship in total...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Complications postopératoires › Infections dues aux prothèses › Hospital volume-outcome relationship in total...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études cliniques comme sujet › Essais cliniques comme sujet › Essais cliniques contrôlés comme sujet › Essais contrôlés randomisés comme sujet › Hospital volume-outcome relationship in total...
questionsmedicales.fr › Procédures de chirurgie opératoire › Réintervention › Hospital volume-outcome relationship in total...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Hospital volume-outcome relationship in total...