Examining racial disparities in utilization rate and perioperative outcomes following knee and hip arthroplasty.

Autor: Thorne T; John A Burns School of Medicine, University of Hawai'i at Manoa, 651 Ilalo Street, Honolulu, HI, 96813, USA., Nishioka S; John A Burns School of Medicine, University of Hawai'i at Manoa, 651 Ilalo Street, Honolulu, HI, 96813, USA., Wong K; John A Burns School of Medicine, University of Hawai'i at Manoa, 651 Ilalo Street, Honolulu, HI, 96813, USA., Lawton DRY; John A Burns School of Medicine, University of Hawai'i at Manoa, 651 Ilalo Street, Honolulu, HI, 96813, USA., Lim SY; Straub Medical Center, Bone and Joint Center, 888 South King Street, Honolulu, HI, 96813, USA., Nakasone CK; John A Burns School of Medicine, University of Hawai'i at Manoa, 651 Ilalo Street, Honolulu, HI, 96813, USA. onohunter@icloud.com.; Straub Medical Center, Bone and Joint Center, 888 South King Street, Honolulu, HI, 96813, USA. onohunter@icloud.com.
Jazyk: angličtina
Zdroj: Archives of orthopaedic and trauma surgery [Arch Orthop Trauma Surg] 2024 May; Vol. 144 (5), pp. 1937-1944. Date of Electronic Publication: 2024 Mar 27.
DOI: 10.1007/s00402-024-05272-y
Abstrakt: Background: Previous arthroplasty utilization research predominantly examined Black and White populations within the US. This is the first known study to examine utilization and complications in poorly studied minority racial groups such as Asians and Native Hawaiian/Pacific-Islanders (NHPI) as compared to Whites.
Results: Data from 3304 primary total hip and knee arthroplasty patients (2011 to 2019) were retrospectively collected, involving 1789 Asians (52.2%), 1164 Whites (34%) and 320 Native Hawaiians/Pacific Islanders (NHPI) (9.3%). The 2012 arthroplasty utilization rates for Asian, White, and NHPI increased by 32.5%, 11.2%, and 86.5%, respectively, by 2019. Compared to Asians, Whites more often underwent hip arthroplasty compared to knee arthroplasty (odds ratio (OR) 1.755; p < 0.001). Compared to Asians, Whites and NHPI more often received total knee compared to unicompartmental knee arthroplasty (White: OR 1.499; NHPI: OR 2.013; p < 0.001). White patients had longer hospitalizations (2.66 days) compared to Asians (2.19 days) (p = 0.005) following bilateral procedures. Medicare was the most common insurance for Asians (66.2%) and Whites (54.2%) while private insurance was most common for NHPI (49.4%). Compared to Asians, economic status was higher for Whites (White OR 0.695; p < 0.001) but lower for NHPI (OR 1.456; p < 0.001). After controlling for bilateral procedures, NHPI had a lower risk of transfusion compared to Asians (OR 0.478; p < 0.001) and Whites had increased risk of wound or systemic complications compared to Asians (OR 2.086; p = 0.045).
Conclusions: Despite NHPI demonstrating a significantly poorer health profile and lower socioeconomic status, contrary to previous literature involving minority racial groups, no significant overall differences in arthroplasty utilization rates or perioperative complications could be demonstrated amongst the racial groups examined.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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