Should we think twice about psychiatric disease in total hip arthroplasty?
Abstract Introduction Psychiatric disease (PD) is common and the effect on complications in total hip arthroplasty (THA) is poorly understood. The purpose of this study is to evaluate the medical and surgical postoperative complication profile in patients with PD and we hypothesize they will be sign...
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| Veröffentlicht in: | The Journal of arthroplasty 2016-09, Vol.31 (9), p.221-226 |
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| creator | Klement, Mitchell R., MD Bala, Abiram, BA Blizzard, Daniel J., MD MS Wellman, Samuel S., MD Bolognesi, Michael P., MD Seyler, Thorsten M., MD, PhD |
| description | Abstract Introduction Psychiatric disease (PD) is common and the effect on complications in total hip arthroplasty (THA) is poorly understood. The purpose of this study is to evaluate the medical and surgical postoperative complication profile in patients with PD and we hypothesize they will be significantly increased compared to control. Methods A search of the entire Medicare database from 2005-2011 was performed using International Classification of Disease version 9 (ICD-9) codes to identify 86,976 patients who underwent primary THA with PD including bipolar (5,626), depression (82,557), and schizophrenia (3,776). A cohort of 590,689 served as a control with minimum 2-year follow-up. Medical and surgical complications at 30-day, 90-day, and overall time points were compared between the two cohorts. Results Patients with PD were more likely to be younger (age |
| doi_str_mv | 10.1016/j.arth.2016.01.063 |
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The purpose of this study is to evaluate the medical and surgical postoperative complication profile in patients with PD and we hypothesize they will be significantly increased compared to control. Methods A search of the entire Medicare database from 2005-2011 was performed using International Classification of Disease version 9 (ICD-9) codes to identify 86,976 patients who underwent primary THA with PD including bipolar (5,626), depression (82,557), and schizophrenia (3,776). A cohort of 590,689 served as a control with minimum 2-year follow-up. Medical and surgical complications at 30-day, 90-day, and overall time points were compared between the two cohorts. Results Patients with PD were more likely to be younger (age <65 OR 4.51, p <0.001), female (OR 2.02, p <0.001), and more medically complex (significant increase in 28/28 Elixhauser medical comorbidities, p <0.001). There was a significant increase (p <0.001) in 13/14 (92.8%) recorded post-operative medical complications rates at the 90-day time point. In addition, there was a statistically significant increase in periprosthetic infection (OR 2.26 p <0.001), periprosthetic fracture (OR 2.09, p <0.001), dislocation (OR 2.30, p <0.001), and THA revision (OR 1.93, p <0.001) at overall follow up. Discussion and Conclusion Patients with PD who undergo elective primary THA have significantly increased medical and surgical complication rates in the global period and short term follow up and these patients need to be counseled accordingly.]]></description><identifier>ISSN: 0883-5403</identifier><identifier>EISSN: 1532-8406</identifier><identifier>DOI: 10.1016/j.arth.2016.01.063</identifier><identifier>PMID: 27067760</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip - adverse effects ; Comorbidity ; complications ; depression ; Elective Surgical Procedures - adverse effects ; Female ; Humans ; Male ; Medicare ; Mental Disorders - complications ; Mental Disorders - epidemiology ; mental health disorder ; Middle Aged ; Odds Ratio ; Orthopedics ; Periprosthetic Fractures - epidemiology ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; psychiatric disease ; Retrospective Studies ; total hip arthroplasty ; United States - epidemiology</subject><ispartof>The Journal of arthroplasty, 2016-09, Vol.31 (9), p.221-226</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-948ab1912384549662d2c2cb70f187c59a0dae7ef8e03bafb73bab4543d8535d3</citedby><cites>FETCH-LOGICAL-c411t-948ab1912384549662d2c2cb70f187c59a0dae7ef8e03bafb73bab4543d8535d3</cites><orcidid>0000-0002-6080-3054</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0883540316002667$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27067760$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Klement, Mitchell R., MD</creatorcontrib><creatorcontrib>Bala, Abiram, BA</creatorcontrib><creatorcontrib>Blizzard, Daniel J., MD MS</creatorcontrib><creatorcontrib>Wellman, Samuel S., MD</creatorcontrib><creatorcontrib>Bolognesi, Michael P., MD</creatorcontrib><creatorcontrib>Seyler, Thorsten M., MD, PhD</creatorcontrib><title>Should we think twice about psychiatric disease in total hip arthroplasty?</title><title>The Journal of arthroplasty</title><addtitle>J Arthroplasty</addtitle><description><![CDATA[Abstract Introduction Psychiatric disease (PD) is common and the effect on complications in total hip arthroplasty (THA) is poorly understood. The purpose of this study is to evaluate the medical and surgical postoperative complication profile in patients with PD and we hypothesize they will be significantly increased compared to control. Methods A search of the entire Medicare database from 2005-2011 was performed using International Classification of Disease version 9 (ICD-9) codes to identify 86,976 patients who underwent primary THA with PD including bipolar (5,626), depression (82,557), and schizophrenia (3,776). A cohort of 590,689 served as a control with minimum 2-year follow-up. Medical and surgical complications at 30-day, 90-day, and overall time points were compared between the two cohorts. Results Patients with PD were more likely to be younger (age <65 OR 4.51, p <0.001), female (OR 2.02, p <0.001), and more medically complex (significant increase in 28/28 Elixhauser medical comorbidities, p <0.001). There was a significant increase (p <0.001) in 13/14 (92.8%) recorded post-operative medical complications rates at the 90-day time point. In addition, there was a statistically significant increase in periprosthetic infection (OR 2.26 p <0.001), periprosthetic fracture (OR 2.09, p <0.001), dislocation (OR 2.30, p <0.001), and THA revision (OR 1.93, p <0.001) at overall follow up. Discussion and Conclusion Patients with PD who undergo elective primary THA have significantly increased medical and surgical complication rates in the global period and short term follow up and these patients need to be counseled accordingly.]]></description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arthroplasty, Replacement, Hip - adverse effects</subject><subject>Comorbidity</subject><subject>complications</subject><subject>depression</subject><subject>Elective Surgical Procedures - adverse effects</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medicare</subject><subject>Mental Disorders - complications</subject><subject>Mental Disorders - epidemiology</subject><subject>mental health disorder</subject><subject>Middle Aged</subject><subject>Odds Ratio</subject><subject>Orthopedics</subject><subject>Periprosthetic Fractures - epidemiology</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>psychiatric disease</subject><subject>Retrospective Studies</subject><subject>total hip arthroplasty</subject><subject>United States - epidemiology</subject><issn>0883-5403</issn><issn>1532-8406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9v1DAQxS0EokvhC3BAPnJJGNuJ45UQqKr4q0ocCmfLsSeKt9k42A7VfnscbeHAAY3k8eG9N5rfEPKSQc2AyTeH2sQ81rz8a2A1SPGI7FgreKUakI_JDpQSVduAuCDPUjoAMNa2zVNywTuQXSdhR77ejmGdHL1Hmkc_39F87y1S04c10yWd7OhNjt5S5xOahNTPNIdsJjr6hW7zY1gmk_Lp_XPyZDBTwhcP_ZL8-Pjh-_Xn6ubbpy_XVzeVbRjL1b5Rpmd7xoVq2mYvJXfcctt3MDDV2XZvwBnscFAIojdD35W3L1LhVCtaJy7J63PuEsPPFVPWR58sTpOZMaxJM8WaUhx4kfKz1MaQUsRBL9EfTTxpBnpjqA9620FvDDUwXRgW06uH_LU_ovtr-QOtCN6eBVi2_OUx6mQ9zhadj2izdsH_P__dP3Y7-dlbM93hCdMhrHEu_DTTiWvQt9sVtyMyCcCl7MRvHhOXWA</recordid><startdate>20160901</startdate><enddate>20160901</enddate><creator>Klement, Mitchell R., MD</creator><creator>Bala, Abiram, BA</creator><creator>Blizzard, Daniel J., MD MS</creator><creator>Wellman, Samuel S., MD</creator><creator>Bolognesi, Michael P., MD</creator><creator>Seyler, Thorsten M., MD, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6080-3054</orcidid></search><sort><creationdate>20160901</creationdate><title>Should we think twice about psychiatric disease in total hip arthroplasty?</title><author>Klement, Mitchell R., MD ; Bala, Abiram, BA ; Blizzard, Daniel J., MD MS ; Wellman, Samuel S., MD ; Bolognesi, Michael P., MD ; Seyler, Thorsten M., MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-948ab1912384549662d2c2cb70f187c59a0dae7ef8e03bafb73bab4543d8535d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arthroplasty, Replacement, Hip - adverse effects</topic><topic>Comorbidity</topic><topic>complications</topic><topic>depression</topic><topic>Elective Surgical Procedures - adverse effects</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medicare</topic><topic>Mental Disorders - complications</topic><topic>Mental Disorders - epidemiology</topic><topic>mental health disorder</topic><topic>Middle Aged</topic><topic>Odds Ratio</topic><topic>Orthopedics</topic><topic>Periprosthetic Fractures - epidemiology</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>psychiatric disease</topic><topic>Retrospective Studies</topic><topic>total hip arthroplasty</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Klement, Mitchell R., MD</creatorcontrib><creatorcontrib>Bala, Abiram, BA</creatorcontrib><creatorcontrib>Blizzard, Daniel J., MD MS</creatorcontrib><creatorcontrib>Wellman, Samuel S., MD</creatorcontrib><creatorcontrib>Bolognesi, Michael P., MD</creatorcontrib><creatorcontrib>Seyler, Thorsten M., MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of arthroplasty</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Klement, Mitchell R., MD</au><au>Bala, Abiram, BA</au><au>Blizzard, Daniel J., MD MS</au><au>Wellman, Samuel S., MD</au><au>Bolognesi, Michael P., MD</au><au>Seyler, Thorsten M., MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Should we think twice about psychiatric disease in total hip arthroplasty?</atitle><jtitle>The Journal of arthroplasty</jtitle><addtitle>J Arthroplasty</addtitle><date>2016-09-01</date><risdate>2016</risdate><volume>31</volume><issue>9</issue><spage>221</spage><epage>226</epage><pages>221-226</pages><issn>0883-5403</issn><eissn>1532-8406</eissn><abstract><![CDATA[Abstract Introduction Psychiatric disease (PD) is common and the effect on complications in total hip arthroplasty (THA) is poorly understood. The purpose of this study is to evaluate the medical and surgical postoperative complication profile in patients with PD and we hypothesize they will be significantly increased compared to control. Methods A search of the entire Medicare database from 2005-2011 was performed using International Classification of Disease version 9 (ICD-9) codes to identify 86,976 patients who underwent primary THA with PD including bipolar (5,626), depression (82,557), and schizophrenia (3,776). A cohort of 590,689 served as a control with minimum 2-year follow-up. Medical and surgical complications at 30-day, 90-day, and overall time points were compared between the two cohorts. Results Patients with PD were more likely to be younger (age <65 OR 4.51, p <0.001), female (OR 2.02, p <0.001), and more medically complex (significant increase in 28/28 Elixhauser medical comorbidities, p <0.001). There was a significant increase (p <0.001) in 13/14 (92.8%) recorded post-operative medical complications rates at the 90-day time point. In addition, there was a statistically significant increase in periprosthetic infection (OR 2.26 p <0.001), periprosthetic fracture (OR 2.09, p <0.001), dislocation (OR 2.30, p <0.001), and THA revision (OR 1.93, p <0.001) at overall follow up. Discussion and Conclusion Patients with PD who undergo elective primary THA have significantly increased medical and surgical complication rates in the global period and short term follow up and these patients need to be counseled accordingly.]]></abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27067760</pmid><doi>10.1016/j.arth.2016.01.063</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-6080-3054</orcidid></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Arthroplasty, Replacement, Hip - adverse effects Comorbidity complications depression Elective Surgical Procedures - adverse effects Female Humans Male Medicare Mental Disorders - complications Mental Disorders - epidemiology mental health disorder Middle Aged Odds Ratio Orthopedics Periprosthetic Fractures - epidemiology Postoperative Complications - epidemiology Postoperative Complications - etiology psychiatric disease Retrospective Studies total hip arthroplasty United States - epidemiology |
| title | Should we think twice about psychiatric disease in total hip arthroplasty? |
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