Differences in Perioperative Outcomes and Complications Between African American and White Patients After Total Joint Arthroplasty
Autor: | Paul J. King, James H. MacDonald, Andrea H. Stone, Maulik S. Joshi |
---|---|
Rok vydání: | 2019 |
Předmět: |
Male
Reoperation medicine.medical_specialty Joint arthroplasty Arthroplasty Replacement Hip Logistic regression White People 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors Odds Ratio medicine Humans Orthopedics and Sports Medicine Risk factor Arthroplasty Replacement Knee Aged Retrospective Studies African american 030222 orthopedics Maryland business.industry Discharge disposition Perioperative Targeted interventions Middle Aged Patient Discharge Black or African American Logistic Models Multivariate Analysis Emergency medicine Female Culturally Competent Care business |
Zdroj: | The Journal of Arthroplasty. 34:656-662 |
ISSN: | 0883-5403 |
Popis: | Racial disparities in healthcare utilization and outcomes have been reported and have wide-reaching implications for individual patient and healthcare system; as providers we bear an ethical burden to address this disparity and provide culturally competent care. This study will examine the influence of race on length of stay, discharge disposition, and complications requiring reoperation following total joint arthroplasty (TJA).Single institution retrospective analysis of a consecutive series of 7208 primary TJA procedures performed between July 2013 and June 2017 was conducted. Chi-squared and t-tests were used to quantify differences between the groups and multiple logistic regression was used to identify race as an independent risk factor.In total, 6182 (84.3%) white and 1026 (14.0%) African American (AA) patients were included. AA patients were younger (63.62 vs 66.84 years, P.001), more likely female (68.8% vs 57.0%, P.001), had a longer length of stay (2.19 vs 2.00 days, P.001), more likely to experience septic complications (1.3% vs 0.5%, P = .002) and manipulation under anesthesia (3.9% vs 1.8%, P.001), and less likely to discharge home (67.1% vs 81.1%, P.001). Multiple logistic regression showed that AA patients were more likely to discharge to a facility (adjusted odds ratio 2.63, 95% confidence interval 2.19-3.16, P.001) and experience a manipulation under anesthesia (adjusted odds ratio 1.90, 95% confidence interval 1.26-2.85, P = .002).AA patients undergoing TJA were younger with longer length of stay and a higher rate of nonhome discharge; AA race was identified as an independent risk factor. Further study is required to understand the differences identified in this study. Targeted interventions should be developed to attempt to eliminate the disparity. |
Databáze: | OpenAIRE |
Externí odkaz: |