Inpatient Dislocation after Primary Total Hip Arthroplasty
Abstract Background Inpatient dislocation after total hip arthroplasty (THA) is considered a non-reimbursable “never event” by the Centers for Medicare and Medicaid Services. There is extensive evidence that technical procedural factors affect dislocation risk, but less is known about the influence...
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| Veröffentlicht in: | The Journal of arthroplasty 2016-12, Vol.31 (12), p.2889-2893 |
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| creator | Menendez, Mariano E., MD Ring, David, MD, PhD Barnes, C. Lowry, MD |
| description | Abstract Background Inpatient dislocation after total hip arthroplasty (THA) is considered a non-reimbursable “never event” by the Centers for Medicare and Medicaid Services. There is extensive evidence that technical procedural factors affect dislocation risk, but less is known about the influence of non-technical factors. We evaluated inpatient dislocation trends following elective primary THA, and identified patient and hospital characteristics associated with the occurrence of dislocation. Methods We used discharge records from the Nationwide Inpatient Sample (2002-2011). Temporal trends were assessed and multivariable logistic regression modeling was used to identify factors associated with dislocation. Results The in-hospital dislocation rate increased from 0.025% in 2002 to 0.15% in 2011, despite a downward trend in length of stay ( P |
| doi_str_mv | 10.1016/j.arth.2016.05.007 |
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Lowry, MD</creator><creatorcontrib>Menendez, Mariano E., MD ; Ring, David, MD, PhD ; Barnes, C. Lowry, MD</creatorcontrib><description>Abstract Background Inpatient dislocation after total hip arthroplasty (THA) is considered a non-reimbursable “never event” by the Centers for Medicare and Medicaid Services. There is extensive evidence that technical procedural factors affect dislocation risk, but less is known about the influence of non-technical factors. We evaluated inpatient dislocation trends following elective primary THA, and identified patient and hospital characteristics associated with the occurrence of dislocation. Methods We used discharge records from the Nationwide Inpatient Sample (2002-2011). Temporal trends were assessed and multivariable logistic regression modeling was used to identify factors associated with dislocation. Results The in-hospital dislocation rate increased from 0.025% in 2002 to 0.15% in 2011, despite a downward trend in length of stay ( P <0.001). Patient characteristics associated with the occurrence of dislocation were black or Hispanic race/ethnicity, lower household income, and Medicaid insurance. Comorbidities associated with dislocation included hemiparesis/hemiplegia, drug use disorder, chronic renal failure, psychosis, and obesity. Dislocations were less likely to occur at teaching hospitals and in the South. Conclusion The in-hospital dislocation rate following elective primary THA is increasing, in spite of shorter stays and surgical advances over time. Given the sociodemographic disparities in dislocation risk documented herein, interventions to address social determinants of health might do as much or more to reduce the occurrence of dislocation than technical improvements.</description><identifier>ISSN: 0883-5403</identifier><identifier>EISSN: 1532-8406</identifier><identifier>DOI: 10.1016/j.arth.2016.05.007</identifier><identifier>PMID: 27318409</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip - adverse effects ; Comorbidity ; dislocation ; Elective Surgical Procedures ; Female ; Hip Dislocation - epidemiology ; Hip Dislocation - etiology ; Hospitals ; Humans ; income ; Inpatients - statistics & numerical data ; Joint Dislocations ; Logistic Models ; Male ; Medicaid ; Medicare ; Middle Aged ; Orthopedics ; outcome ; Patient Discharge ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; race ; Retrospective Studies ; total hip arthroplasty ; United States - epidemiology</subject><ispartof>The Journal of arthroplasty, 2016-12, Vol.31 (12), p.2889-2893</ispartof><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-93c628445174fdfcfce42dafc1514de3b70b15e42da24da5367b9252cac75c373</citedby><cites>FETCH-LOGICAL-c411t-93c628445174fdfcfce42dafc1514de3b70b15e42da24da5367b9252cac75c373</cites><orcidid>0000-0003-3776-5384</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.arth.2016.05.007$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27318409$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Menendez, Mariano E., MD</creatorcontrib><creatorcontrib>Ring, David, MD, PhD</creatorcontrib><creatorcontrib>Barnes, C. Lowry, MD</creatorcontrib><title>Inpatient Dislocation after Primary Total Hip Arthroplasty</title><title>The Journal of arthroplasty</title><addtitle>J Arthroplasty</addtitle><description>Abstract Background Inpatient dislocation after total hip arthroplasty (THA) is considered a non-reimbursable “never event” by the Centers for Medicare and Medicaid Services. There is extensive evidence that technical procedural factors affect dislocation risk, but less is known about the influence of non-technical factors. We evaluated inpatient dislocation trends following elective primary THA, and identified patient and hospital characteristics associated with the occurrence of dislocation. Methods We used discharge records from the Nationwide Inpatient Sample (2002-2011). Temporal trends were assessed and multivariable logistic regression modeling was used to identify factors associated with dislocation. Results The in-hospital dislocation rate increased from 0.025% in 2002 to 0.15% in 2011, despite a downward trend in length of stay ( P <0.001). Patient characteristics associated with the occurrence of dislocation were black or Hispanic race/ethnicity, lower household income, and Medicaid insurance. Comorbidities associated with dislocation included hemiparesis/hemiplegia, drug use disorder, chronic renal failure, psychosis, and obesity. Dislocations were less likely to occur at teaching hospitals and in the South. Conclusion The in-hospital dislocation rate following elective primary THA is increasing, in spite of shorter stays and surgical advances over time. Given the sociodemographic disparities in dislocation risk documented herein, interventions to address social determinants of health might do as much or more to reduce the occurrence of dislocation than technical improvements.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arthroplasty, Replacement, Hip - adverse effects</subject><subject>Comorbidity</subject><subject>dislocation</subject><subject>Elective Surgical Procedures</subject><subject>Female</subject><subject>Hip Dislocation - epidemiology</subject><subject>Hip Dislocation - etiology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>income</subject><subject>Inpatients - statistics & numerical data</subject><subject>Joint Dislocations</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medicaid</subject><subject>Medicare</subject><subject>Middle Aged</subject><subject>Orthopedics</subject><subject>outcome</subject><subject>Patient Discharge</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>race</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>eNp9kUtLxDAUhYMoOj7-gAvp0k1rbh5NR0QYfMOAguM6ZNIUM3aammSE-femjrpw4ermhnPO5X4XoWPABWAozxaF8vG1IOldYF5gLLbQCDglecVwuY1GuKpozhmme2g_hAXGAJyzXbRHBIWkGY_Q-UPXq2hNF7NrG1qnU-O6TDXR-OzJ26Xy62zmomqze9tnkzTQu75VIa4P0U6j2mCOvusBerm9mV3d59PHu4eryTTXDCDmY6pLUjHGQbCmbnSjDSO1ajRwYLWhc4HnwL_-CKsVp6WYjwknWmnBNRX0AJ1ucnvv3lcmRLm0QZu2VZ1xqyChIqXAgvAySclGqr0LwZtG9psVJGA5MJMLOTCTAzOJuUzMkunkO381X5r61_IDKQkuNgKTtvywxsugEzFtauuNjrJ29v_8yz923drOatW-mbUJC7fyXeInQQYisXwerjYcDUqKgRFOPwGmO5Gx</recordid><startdate>20161201</startdate><enddate>20161201</enddate><creator>Menendez, Mariano E., MD</creator><creator>Ring, David, MD, PhD</creator><creator>Barnes, C. Lowry, MD</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/0000-0003-3776-5384</orcidid></search><sort><creationdate>20161201</creationdate><title>Inpatient Dislocation after Primary Total Hip Arthroplasty</title><author>Menendez, Mariano E., MD ; Ring, David, MD, PhD ; Barnes, C. Lowry, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-93c628445174fdfcfce42dafc1514de3b70b15e42da24da5367b9252cac75c373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arthroplasty, Replacement, Hip - adverse effects</topic><topic>Comorbidity</topic><topic>dislocation</topic><topic>Elective Surgical Procedures</topic><topic>Female</topic><topic>Hip Dislocation - epidemiology</topic><topic>Hip Dislocation - etiology</topic><topic>Hospitals</topic><topic>Humans</topic><topic>income</topic><topic>Inpatients - statistics & numerical data</topic><topic>Joint Dislocations</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medicaid</topic><topic>Medicare</topic><topic>Middle Aged</topic><topic>Orthopedics</topic><topic>outcome</topic><topic>Patient Discharge</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>race</topic><topic>Retrospective Studies</topic><topic>total hip arthroplasty</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Menendez, Mariano E., MD</creatorcontrib><creatorcontrib>Ring, David, MD, PhD</creatorcontrib><creatorcontrib>Barnes, C. Lowry, MD</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>Menendez, Mariano E., MD</au><au>Ring, David, MD, PhD</au><au>Barnes, C. Lowry, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Inpatient Dislocation after Primary Total Hip Arthroplasty</atitle><jtitle>The Journal of arthroplasty</jtitle><addtitle>J Arthroplasty</addtitle><date>2016-12-01</date><risdate>2016</risdate><volume>31</volume><issue>12</issue><spage>2889</spage><epage>2893</epage><pages>2889-2893</pages><issn>0883-5403</issn><eissn>1532-8406</eissn><abstract>Abstract Background Inpatient dislocation after total hip arthroplasty (THA) is considered a non-reimbursable “never event” by the Centers for Medicare and Medicaid Services. There is extensive evidence that technical procedural factors affect dislocation risk, but less is known about the influence of non-technical factors. We evaluated inpatient dislocation trends following elective primary THA, and identified patient and hospital characteristics associated with the occurrence of dislocation. Methods We used discharge records from the Nationwide Inpatient Sample (2002-2011). Temporal trends were assessed and multivariable logistic regression modeling was used to identify factors associated with dislocation. Results The in-hospital dislocation rate increased from 0.025% in 2002 to 0.15% in 2011, despite a downward trend in length of stay ( P <0.001). Patient characteristics associated with the occurrence of dislocation were black or Hispanic race/ethnicity, lower household income, and Medicaid insurance. Comorbidities associated with dislocation included hemiparesis/hemiplegia, drug use disorder, chronic renal failure, psychosis, and obesity. Dislocations were less likely to occur at teaching hospitals and in the South. Conclusion The in-hospital dislocation rate following elective primary THA is increasing, in spite of shorter stays and surgical advances over time. Given the sociodemographic disparities in dislocation risk documented herein, interventions to address social determinants of health might do as much or more to reduce the occurrence of dislocation than technical improvements.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27318409</pmid><doi>10.1016/j.arth.2016.05.007</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-3776-5384</orcidid></addata></record> |
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| subjects | Aged Aged, 80 and over Arthroplasty, Replacement, Hip - adverse effects Comorbidity dislocation Elective Surgical Procedures Female Hip Dislocation - epidemiology Hip Dislocation - etiology Hospitals Humans income Inpatients - statistics & numerical data Joint Dislocations Logistic Models Male Medicaid Medicare Middle Aged Orthopedics outcome Patient Discharge Postoperative Complications - epidemiology Postoperative Complications - etiology race Retrospective Studies total hip arthroplasty United States - epidemiology |
| title | Inpatient Dislocation after Primary Total Hip Arthroplasty |
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