The Impact of Race and Socioeconomic Status on Total Joint Arthroplasty Care.

Autor: Suleiman LI; Department of Orthopaedic Surgery, Northwestern Medicine Feinberg School of Medicine, Chicago, IL., Manista GC; Department of Orthopaedic Surgery, Midwest Orthopaedics at Rush, Chicago, IL., Sherman AE; Department of Orthopaedic Surgery, Northwestern Medicine Feinberg School of Medicine, Chicago, IL., Adhia AH; Department of Orthopaedic Surgery, Northwestern Medicine Feinberg School of Medicine, Chicago, IL., Karas V; Department of Orthopaedic Surgery, Midwest Orthopaedics at Rush, Chicago, IL., Sporer SM; Department of Orthopaedic Surgery, Midwest Orthopaedics at Rush, Chicago, IL., Levine BR; Department of Orthopaedic Surgery, Midwest Orthopaedics at Rush, Chicago, IL.
Jazyk: angličtina
Zdroj: The Journal of arthroplasty [J Arthroplasty] 2021 Aug; Vol. 36 (8), pp. 2729-2733. Date of Electronic Publication: 2021 Mar 05.
DOI: 10.1016/j.arth.2021.03.002
Abstrakt: Background: Racial minorities and patients from lower socioeconomic backgrounds are less likely to undergo total joint arthroplasty (TJA) for degenerative joint disease (DJD). However, when these patients do present for care, little is known about the overall severity of DJD and surgical wait times.
Methods: A retrospective cohort of 407 patients (131 black and 276 white) who presented to an arthroplasty clinic and went on to receive TJA was established. Severity of osteoarthritis was assessed radiographically via Kellgren-Lawrence (KL) grade. Preoperative Knee Society Score (KSS) and Harris Hip Score (HHS) were used to measure joint pain and function. Multivariate regression modeling and analysis of covariance were used to examine racial and socioeconomic differences in KL grade, KSS, HHS, and time to surgery.
Results: Black patients presented with significantly greater KL scores than white patients (P = .046, odds ratio = 1.65, 95% confidence interval [1.01, 2.70]). In contrast, there were no statistically significant racial differences in the mean preoperative KSS (P = .61) or HHS (P = .69). Black patients were also found to wait, on average, 35% longer for TJA (P = .03, hazard ratio = 1.35, 95% confidence interval [1.04, 1.75]). Low income was associated with higher KL grade (P = .002), lower KSS (P = .07), and lower HHS (P = .001).
Conclusion: Despite presenting with more advanced osteoarthritis, black patients reported similar levels of joint dysfunction and had longer surgical wait times when compared with white patients. Lower socioeconomic status was similarly associated with more severe DJD.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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