Elective Inpatient Total Joint Arthroplasty Case Volume in the United States in 2020: Effects of the COVID-19 Pandemic.


Journal

The Journal of bone and joint surgery. American volume
ISSN: 1535-1386
Titre abrégé: J Bone Joint Surg Am
Pays: United States
ID NLM: 0014030

Informations de publication

Date de publication:
06 07 2022
Historique:
pubmed: 12 3 2022
medline: 9 7 2022
entrez: 11 3 2022
Statut: ppublish

Résumé

Despite known surgical volume reductions in 2020 during the height of the COVID-19 pandemic, no study has fully quantified the impact of the pandemic on the number of elective inpatient total hip (THA) and total knee arthroplasty (TKA) cases. The purpose of the present study was to analyze THA and TKA case volumes in the United States during the COVID-19 pandemic. The Premier Healthcare Database was utilized to identify adults undergoing primary elective THA or TKA from January 2017 to December 2020. The National Inpatient Sample was cross-referenced to provide nationwide representative sampling weights. Patients undergoing revision total joint arthroplasty (TJA) or non-elective surgery were excluded. Two quantitative models were created from both databases to estimate TJA case volume in 2020. Descriptive statistics were utilized to report monthly changes in elective TJA utilization throughout 2020. Univariate analyses were performed to compare differences between subgroups. From 2017 to 2019, it was estimated that 1,006,000 elective inpatient TJAs (64.2% TKA and 35.8% THA) were performed annually. In 2020, an estimated 526,000 to 538,000 cases (62.0% TKA and 38.0% THA) were performed, representing a 46.5% to 47.7% decrease in nationwide volume from the prior 3-year average. Moreover, the elective TJA case volume for April 2020 was 1.9% of the average for that month from 2017 through 2019. Subsequently, case volumes for May and June increased compared with the volumes for those months from 2017 through 2019. There was then a decrease in cases for July, corresponding with the "second wave" of COVID-19, followed by an additional steady monthly decline through December, corresponding with the "third wave." Finally, the elective TJA cases for December 2020 represented only 41.0% of the average case volume for that month from 2017 through 2019. In the midst of the 2020 COVID-19 pandemic, approximately 526,000 to 538,000 elective inpatient TJA cases were performed, representing a 46.5% to 47.7% decrease compared with the 3 previous years. The effects of the COVID-19 pandemic persisted through the end of that year, with decreased case volume through December 2020.

Sections du résumé

BACKGROUND
Despite known surgical volume reductions in 2020 during the height of the COVID-19 pandemic, no study has fully quantified the impact of the pandemic on the number of elective inpatient total hip (THA) and total knee arthroplasty (TKA) cases. The purpose of the present study was to analyze THA and TKA case volumes in the United States during the COVID-19 pandemic.
METHODS
The Premier Healthcare Database was utilized to identify adults undergoing primary elective THA or TKA from January 2017 to December 2020. The National Inpatient Sample was cross-referenced to provide nationwide representative sampling weights. Patients undergoing revision total joint arthroplasty (TJA) or non-elective surgery were excluded. Two quantitative models were created from both databases to estimate TJA case volume in 2020. Descriptive statistics were utilized to report monthly changes in elective TJA utilization throughout 2020. Univariate analyses were performed to compare differences between subgroups.
RESULTS
From 2017 to 2019, it was estimated that 1,006,000 elective inpatient TJAs (64.2% TKA and 35.8% THA) were performed annually. In 2020, an estimated 526,000 to 538,000 cases (62.0% TKA and 38.0% THA) were performed, representing a 46.5% to 47.7% decrease in nationwide volume from the prior 3-year average. Moreover, the elective TJA case volume for April 2020 was 1.9% of the average for that month from 2017 through 2019. Subsequently, case volumes for May and June increased compared with the volumes for those months from 2017 through 2019. There was then a decrease in cases for July, corresponding with the "second wave" of COVID-19, followed by an additional steady monthly decline through December, corresponding with the "third wave." Finally, the elective TJA cases for December 2020 represented only 41.0% of the average case volume for that month from 2017 through 2019.
CONCLUSIONS
In the midst of the 2020 COVID-19 pandemic, approximately 526,000 to 538,000 elective inpatient TJA cases were performed, representing a 46.5% to 47.7% decrease compared with the 3 previous years. The effects of the COVID-19 pandemic persisted through the end of that year, with decreased case volume through December 2020.

Identifiants

pubmed: 35275853
doi: 10.2106/JBJS.21.00833
pii: 00004623-202207060-00013
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e56

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2022 by The Journal of Bone and Joint Surgery, Incorporated.

Déclaration de conflit d'intérêts

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article ( http://links.lww.com/JBJS/G959 ).

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Auteurs

Nathanael D Heckmann (ND)

Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California.

Gabriel J Bouz (GJ)

Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California.

Amit S Piple (AS)

Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California.

Brian C Chung (BC)

Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California.

Jennifer C Wang (JC)

Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California.

Cory K Mayfield (CK)

Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California.

Jeffrey B Stambough (JB)

Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas.

Daniel A Oakes (DA)

Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California.

Alexander B Christ (AB)

Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California.

Jay R Lieberman (JR)

Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California.

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