Provider Volume of Total Knee Arthroplasties and Patient Outcomes in the Hcup-Nationwide Inpatient Sample

Hervey, Sheleika; Purves, Harriett; Güller, Ulrich; Toth, Alison P.; Vail, Thomas P.; Pietrobon, Ricardo

doi:10.2106/00004623-200309000-00017

Cited by 187 publications

(131 citation statements)

References 20 publications

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“…No statistically significant differences between primary and revision surgery were found with regard to PE outcome. The PE rates in the present study were also lower than in the Medicare population, and are consistent with published rates from smaller studies (Mantilla et al 2002, Bullock et al 2003, Hervey et al 2003, Feinglass et al 2004a.…”

Section: Discussionsupporting

confidence: 92%

Knee replacement: epidemiology, outcomes, and trends in Southern California 17,080 replacements from 1995 through 2004

Khatod

Inacio²,

Paxton³

et al. 2008

Acta Orthopaedica

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Background and purpose There are limited population-based data on utilization, outcomes, and trends in total knee arthroplasty (TKA). The purpose of this study was to examine TKA utilization and short-term outcomes in a pre-paid health maintenance organization (HMO), and to determine whether rates and revision burden changed over time. We also studied whether this population is representative of the general population in California and in the United States.Methods Using hospital utilization and membership databases from 1995 through 2004, we calculated incidence rates (IRs) of primary and revision TKA for every 10,000 health plan members. The demographics of the HMO population were compared to published census data from California and the United States.Results

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Section: Discussionsupporting

confidence: 92%

Knee replacement: epidemiology, outcomes, and trends in Southern California 17,080 replacements from 1995 through 2004

Khatod

Inacio²,

Paxton³

et al. 2008

Acta Orthopaedica

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“…High surgeon or hospital volume is associated with better outcomes in terms of medical utilization and complications/mortality for TJR procedures. [14][15][16] High surgical volumes increase the opportunity to improve surgical skills and implement a Neuraxial anesthesia and long-term survival 373 Fig. 2 Five-year overall survival rate after TJR between GA and NA.…”

Section: Discussionmentioning

confidence: 99%

“…We chose cutoff points to divide the study population into approximately quarters for each of the years under study (1997 through 2010). [14][15][16] Hospitals/surgeons that fell in the highest quartile for the numbers of TJRs performed were considered ''high-volume'' hospitals/surgeons, and the others were ''low-volume'' hospitals/surgeons.…”

Section: Potential Confoundersmentioning

confidence: 99%

Neuraxial anesthesia improves long-term survival after total joint replacement: a retrospective nationwide population-based study in Taiwan

Chen

Hung

Tan

et al. 2015

Can J Anesth/J Can Anesth

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Introduction This study explored the effects of general (GA) and neuraxial (NA) anesthesia on the outcomes of primary total joint replacement (TJR) in terms of postoperative mortality, length of stay (LOS), and hospital treatment costs. Methods From 1997 to 2010, this nationwide population-based study retrospectively evaluated 7,977 patients in Taiwan who underwent primary total hip or knee replacement. We generated two propensity-scorematched subgroups, each containing an equal number of patients who underwent TJR with either GA or NA. Results Of the 7,977 patients, 2,990 (37.5%) underwent GA and 4,987 (62.5%) underwent NA. Propensity-score matching was used to create comparable GA and NA groups adjusted for age, sex, comorbidities, surgery type, hospital volume, and surgeon volume. Survival over the first three years following surgery was similar. The proportion of patients alive up to 14 years postoperatively for those undergoing NA was 58.2% (95% confidence interval [CI] 50.4 to 66.0), and for those undergoing GA it was 57.3% (95% CI 51.4 to 63.2). Neuraxial anesthesia was associated with lower median [interquartile range; IQR] hospital treatment cost ($4,079 [3,805-4,444] vs $4,113 [3,812-4,568]; P \ 0.001) and shorter median days vs 8 [6-10] days, respectively; P = 0.024). Conclusions Our results support the use of NA for primary TJR. The improvements in hospital costs persist even when anesthesia costs are removed. The mechanism underlying the association between NA and long-term survival is unknown.

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“…Studies indicate that hip and knee replacements surgeries performed by inexperienced surgeons have overall poorer results and 11 times more likely to fail than those done by an experienced surgeon. 9,10 To enhance quality of surgery, it is essential that variability is reduced between centers and this can be achieved if a minimum standard framework is universally applied across all centers practicing joint replacement. These minimum standards should include following aspects: To this end, the AFMS has introduced a number of measures.…”

Section: The Way Ahead…mentioning

confidence: 99%

Joint replacement surgery in the Armed Forces Medical Services, India: The journey so far and looking ahead

Chopra

2015

Medical Journal Armed Forces India

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Provider Volume of Total Knee Arthroplasties and Patient Outcomes in the Hcup-Nationwide Inpatient Sample

Cited by 187 publications

References 20 publications

Knee replacement: epidemiology, outcomes, and trends in Southern California 17,080 replacements from 1995 through 2004

Knee replacement: epidemiology, outcomes, and trends in Southern California 17,080 replacements from 1995 through 2004

Neuraxial anesthesia improves long-term survival after total joint replacement: a retrospective nationwide population-based study in Taiwan

Joint replacement surgery in the Armed Forces Medical Services, India: The journey so far and looking ahead

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