Alex Upfill-Brown1, Noah Paisner1,2, Adam Sassoon3. 1. Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, 1225 15thSt, Suite 3145, Santa Monica, CA, 90404, USA. 2. Pacific Northwest University School of Health Sciences, Yakima, WA, USA. 3. Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, 1225 15thSt, Suite 3145, Santa Monica, CA, 90404, USA. asassoon@mednet.ucla.edu.
Abstract
INTRODUCTION: The objective of this study was to explore race-based differences in 30-day complication rates following total joint arthroplasty (TJA) using a large national database. METHODS: Patients undergoing primary, elective THA and TKA between 2012 and 2018 were retrospectively reviewed using the ACS-NSQIP. We compared Black and Hispanic patients with non-Hispanic White patients using multivariate statistical models adjusting for demographic, operative, and medical characteristics. RESULTS: A total of 324,795 and 200,023 patients undergoing THA and TKA, respectively, were identified. After THA, compared to White patients, Black and Hispanic patients were more likely to be diagnosed with VTE (p < 0.001), receive a blood transfusion (p < 0.001), and to be discharged to an inpatient facility (p < 0.001). After TKA, compared to White patients, Black and Hispanic patients were more likely to experience a major complication (p < 0.001 and p = 0.008, respectively), be diagnosed with VTE (p < 0.001), and be discharged to a facility (p < 0.001). CONCLUSIONS: Our findings indicate higher rates of VTE, blood transfusions, and discharge to an inpatient facility for Black and Hispanic patients when compared to White patients following TJA, though we are unable to comment on the etiology of these disparities. These results may contribute to a growing divide with respect to outcomes and access to TJA for these at-risk patient populations.
INTRODUCTION: The objective of this study was to explore race-based differences in 30-day complication rates following total joint arthroplasty (TJA) using a large national database. METHODS: Patients undergoing primary, elective THA and TKA between 2012 and 2018 were retrospectively reviewed using the ACS-NSQIP. We compared Black and Hispanic patients with non-Hispanic White patients using multivariate statistical models adjusting for demographic, operative, and medical characteristics. RESULTS: A total of 324,795 and 200,023 patients undergoing THA and TKA, respectively, were identified. After THA, compared to White patients, Black and Hispanic patients were more likely to be diagnosed with VTE (p < 0.001), receive a blood transfusion (p < 0.001), and to be discharged to an inpatient facility (p < 0.001). After TKA, compared to White patients, Black and Hispanic patients were more likely to experience a major complication (p < 0.001 and p = 0.008, respectively), be diagnosed with VTE (p < 0.001), and be discharged to a facility (p < 0.001). CONCLUSIONS: Our findings indicate higher rates of VTE, blood transfusions, and discharge to an inpatient facility for Black and Hispanic patients when compared to White patients following TJA, though we are unable to comment on the etiology of these disparities. These results may contribute to a growing divide with respect to outcomes and access to TJA for these at-risk patient populations.
Authors: Said A Ibrahim; Roslyn A Stone; Xiaoyan Han; Peter Cohen; Michael J Fine; William G Henderson; Shukri F Khuri; C Kent Kwoh Journal: Arthritis Rheum Date: 2005-10
Authors: Joanne M Jordan; Charles G Helmick; Jordan B Renner; Gheorghe Luta; Anca D Dragomir; Janice Woodard; Fang Fang; Todd A Schwartz; Lauren M Abbate; Leigh F Callahan; William D Kalsbeek; Marc C Hochberg Journal: J Rheumatol Date: 2007-01 Impact factor: 4.666
Authors: Wei Zhang; Stephen Lyman; Carla Boutin-Foster; Michael L Parks; Ting-Jung Pan; Alexis Lan; Yan Ma Journal: J Bone Joint Surg Am Date: 2016-08-03 Impact factor: 5.284
Authors: Martin Roche; Tsun Yee Law; Assem A Sultan; Erica Umpierrez; Anton Khlopas; Sam Rosas; Jennifer Kurowicki; Kevin Wang; Michael A Mont Journal: J Racial Ethn Health Disparities Date: 2018-06-18
Authors: Todd P Pierce; Randa K Elmallah; Carlos J Lavernia; Antonia F Chen; Steven F Harwin; Craig M Thomas; Michael A Mont Journal: Orthopedics Date: 2015-12 Impact factor: 1.390