OBJECTIVE: To describe inpatient complications for primary total knee replacement (TKR) in a period of rapidly growing orthopedic surgery capacity, declining length of stay, and more frequent discharge to rehabilitation facilities. METHODS: Complication incidence according to published coding algorithms was estimated for 35,531 primary TKR admissions of northern Illinois residents to 65 Illinois hospitals. Complication odds were estimated as a function of patients' clinical and sociodemographic status, hospital volume, residency training, TKR length of stay, International Classification of Diseases, Ninth Revision (ICD-9) coding intensity, and discharges to skilled nursing or rehabilitation facilities. RESULTS: Primary TKR admissions increased 36% between 1993 and 1999, length of stay declined 43%, average ICD-9 code use increased 31%, and rehabilitation discharges increased 68%. Major complication rates declined 44% (12.4% to 6.9%; P < 0.0001) over this period, reflecting a 50% reduction in the adjusted odds of complication between 1993 and 1999. There was no association of procedure volume and outcome. CONCLUSION: It is likely that the reduction in complications reflects true safety improvements as well as reduced length of stay.
OBJECTIVE: To describe inpatient complications for primary total knee replacement (TKR) in a period of rapidly growing orthopedic surgery capacity, declining length of stay, and more frequent discharge to rehabilitation facilities. METHODS: Complication incidence according to published coding algorithms was estimated for 35,531 primary TKR admissions of northern Illinois residents to 65 Illinois hospitals. Complication odds were estimated as a function of patients' clinical and sociodemographic status, hospital volume, residency training, TKR length of stay, International Classification of Diseases, Ninth Revision (ICD-9) coding intensity, and discharges to skilled nursing or rehabilitation facilities. RESULTS: Primary TKR admissions increased 36% between 1993 and 1999, length of stay declined 43%, average ICD-9 code use increased 31%, and rehabilitation discharges increased 68%. Major complication rates declined 44% (12.4% to 6.9%; P < 0.0001) over this period, reflecting a 50% reduction in the adjusted odds of complication between 1993 and 1999. There was no association of procedure volume and outcome. CONCLUSION: It is likely that the reduction in complications reflects true safety improvements as well as reduced length of stay.
Authors: G Hawker; J Wright; P Coyte; J Paul; R Dittus; R Croxford; B Katz; C Bombardier; D Heck; D Freund Journal: J Bone Joint Surg Am Date: 1998-02 Impact factor: 5.284
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Authors: C M Kugler; K Goossen; T Rombey; K K De Santis; T Mathes; J Breuing; S Hess; R Burchard; D Pieper Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-09-08 Impact factor: 4.114