Influence of Hospital Volume of Procedures by Year on the Risk of Revision of Total Hip and Knee Arthroplasties: A Propensity Score-Matched Cohort Study

Autor:	Vicente Martín, Olga Martínez, Jorge Torre, Kayla Smith, Miquel Pons-Cabrafiga, Jonathan P Evans, Mireia Espallargues, Jose M Valderas, Francesc Pallisó, Antonio J. Molina
Rok vydání:	2019
Předmět:	musculoskeletal diseases Matching (statistics) medicine.medical_specialty total knee arthroplasty revision total hip arthroplasty medicine.medical_treatment Total hip replacement lcsh:Medicine Osteoarthritis Article 03 medical and health sciences 0302 clinical medicine Hospital volume hospital volume Medicine 030203 arthritis & rheumatology 030222 orthopedics business.industry Incidence (epidemiology) lcsh:R Confounding register studies General Medicine medicine.disease musculoskeletal system Arthroplasty surgical procedures operative Propensity score matching Physical therapy business
Zdroj:	Journal of Clinical Medicine Volume 8 Issue 5 Journal of Clinical Medicine, Vol 8, Iss 5, p 670 (2019)
ISSN:	2077-0383
Popis:	The volume of total hip (THA) and knee arthroplasties (TKA) performed in a hospital per year could be an influential factor on the revision of these procedures. The aims of this study were: To obtain comparable cohorts in higher- and lower-volume hospitals and to assess the association between the hospital volume and the incidence of revision. Data from patients undergoing THA and TKA caused by osteoarthritis and recorded in the Catalan Arthroplasty Register (RACat) between January 2005 and December 2016 were used. The main explanatory variable was hospital volume by year (higher/lower). The cut-off point was fixed, based on previous research, at 50 THA and 125 TKA procedures/year. To obtain comparable populations, a propensity-score matching method (1:1) was used. Patient characteristics prior to and after matching were compared. To assess differences by volume, subhazard ratios (SHRs) from competing risks models were obtained. After matching, 13,772 THA and 36,316 TKA patients remained in the study. Prior to matching, in both joints, significant differences in all confounders were observed between volume groups. After matching, none of them remained significant. Both in THA and TKA, a higher risk of revision in higher-volume hospitals was observed (THA SHR: 1.25, 95%CI: 1.02&ndash 1.53 and TKA SHR: 1.29, 95%CI: 1.16&ndash 1.44). Unlike other contexts, currently in Catalonia, higher-volume hospitals have a greater risk of revision than lower-volume hospitals. Further research could be valuable to define context-dependent measures to reduce the incidence of revision.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9aeeda57800c9ee9560eee7a06171e7d https://pubmed.ncbi.nlm.nih.gov/31086009 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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