Impact of Cirrhosis on Resource Use and Inpatient Complications in Patients Undergoing Total Knee and Hip Arthroplasty
| Autor: | Jared M. Newman, Christopher D. Mudd, Alison K. Klika, Nicholas K. Schiltz, Wael K. Barsoum, Caleb R. Szubski |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
musculoskeletal diseases
Adult Liver Cirrhosis Male medicine.medical_specialty Cirrhosis Hepatitis Viral Human Arthroplasty Replacement Hip Subgroup analysis Comorbidity Article 03 medical and health sciences 0302 clinical medicine Postoperative Complications Liver Cirrhosis Alcoholic Risk Factors medicine Humans Orthopedics and Sports Medicine Risk factor Arthroplasty Replacement Knee Aged Retrospective Studies Aged 80 and over 030222 orthopedics Inpatients business.industry Retrospective cohort study Perioperative Length of Stay Middle Aged musculoskeletal system medicine.disease Confidence interval Surgery surgical procedures operative Health Resources 030211 gastroenterology & hepatology Female business Complication |
| Popis: | Background Cirrhosis is a major cause of morbidity and mortality and is an important risk factor for complications in surgical patients. The purpose of this study was to investigate the association of cirrhosis with postoperative complications, length of stay (LOS), and costs among patients who underwent total knee arthroplasty (TKA) or total hip arthroplasty (THA). Methods Using the Nationwide Inpatient Sample between 2000 and 2011, we identified patients who had a primary TKA or primary THA. TKA patients were divided into 2 groups: (1) cirrhosis (n = 41,464) and (2) no cirrhosis (n = 5,721,297) and THA patients were divided into 2 groups: (1) cirrhosis (n = 27,401) and (2) no cirrhosis (n = 2,622,539). Patient demographics, comorbidities, perioperative complications, LOS, and incremental costs were analyzed. An additional subgroup analysis by cirrhosis etiology was performed. Results Multivariable analysis revealed cirrhosis was associated with 1.55 (95% confidence interval: 1.47-1.63) times higher odds of any complication after TKA and 1.59 (1.50-1.69) higher odds after THA. Adjusted outcomes showed cirrhotic TKA patients had $1857 higher costs and 0.30 days longer LOS and THA cirrhotic patients had $1497 higher costs and 0.48 longer LOS. We found similar results for each cirrhosis subtype but alcohol-related had the highest resource use and complication rate. Conclusion Patients with cirrhosis who are undergoing TKA or THA are at a significantly increased risk for perioperative complications, increased LOS, and higher costs. The perioperative complications and costs were highest among patients with alcohol-related cirrhosis. |
| Databáze: | OpenAIRE |
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