دورية أكاديمية
أعرض في EDS

The Association of Race/Ethnicity and Total Knee Arthroplasty Outcomes in a Universally Insured Population.

التفاصيل البيبلوغرافية
العنوان: The Association of Race/Ethnicity and Total Knee Arthroplasty Outcomes in a Universally Insured Population.
المؤلفون: Hinman AD; Department of Orthopaedic Surgery, The Permanente Medical Group, San Leandro, CA., Chan PH; Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, CA., Prentice HA; Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, CA., Paxton EW; Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, CA., Okike KM; Department of Orthopaedic Surgery, Kaiser Moanalua Medical Center, Honolulu, HI., Navarro RA; Department of Orthopaedic Surgery, Southern California Permanente Medical Group, Harbor City, CA.
المصدر: The Journal of arthroplasty [J Arthroplasty] 2020 Jun; Vol. 35 (6), pp. 1474-1479. Date of Electronic Publication: 2020 Feb 08.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Taylor and Francis Country of Publication: United States NLM ID: 8703515 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8406 (Electronic) Linking ISSN: 08835403 NLM ISO Abbreviation: J Arthroplasty Subsets: MEDLINE
أسماء مطبوعة: Publication: New Brunswick, NJ : Taylor and Francis
Original Publication: [New York, NY : Churchill Livingstone, c1986-
مواضيع طبية MeSH: Arthroplasty, Replacement, Knee*/adverse effects, Black or African American ; Elective Surgical Procedures ; Ethnicity ; Hispanic or Latino ; Humans ; Retrospective Studies ; United States/epidemiology
مستخلص: Background: Prior studies have documented racial/ethnic disparities in the United States for total knee arthroplasty (TKA) outcomes. One factor cited as a potential mediator is unequal access to care. We sought to assess whether racial/ethnic disparities persist in a universally insured TKA population.
Methods: A US integrated health system's total joint replacement registry was used to identify elective primary TKA (2000-2016). Racial/ethnic differences in revision and 90-day postoperative events (readmission, emergency department [ED] visit, infection, venous thromboembolism, and mortality) were analyzed using Cox proportional hazard and logistic regression with adjustment for confounders.
Results: Of 129,402 TKA, 68.8% were white, 16.2% were Hispanic, 8.4% were black, and 6.6% were Asian. Compared to white patients, Hispanic patients had lower risks of septic revision (hazard ratio [HR] = 0.69, 95% confidence interval [CI] = 0.57-0.83) and infection (odds ratio [OR] = 0.42, 95% CI = 0.30-0.59), but a higher likelihood of ED visit (OR = 1.28, 95% CI = 1.22-1.34). Black patients had higher risks of aseptic revision (HR = 1.61, 95% CI = 1.42-1.83), readmission (OR = 1.13, 95% CI = 1.02-1.24), and ED visit (OR = 1.31, 95% CI = 1.23-1.39). Asian patients had lower risks of aseptic revision (HR = 0.67, 95% CI = 0.54-0.83), septic revision (HR = 0.78, 95% CI = 0.60-0.99), readmission (OR = 0.89, 95% CI = 0.79-1.00), and venous thromboembolism (OR = 0.59, 95% CI = 0.45-0.78).
Conclusion: We observed differences in TKA outcome, even within a universally insured population. While lower risks in some outcomes were observed for Asian and Hispanic patients, the higher risks of aseptic revision and readmission for black patients and ED visit for black and Hispanic patients warrant further research to determine reasons for these findings to mitigate disparities.
Level of Evidence: Level III.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: emergency department visit; race; readmission; revision surgery; total knee arthroplasty
تواريخ الأحداث: Date Created: 20200309 Date Completed: 20210315 Latest Revision: 20221207
رمز التحديث: 20221213
DOI: 10.1016/j.arth.2020.02.002
PMID: 32146110
قاعدة البيانات: MEDLINE
الوصف
تدمد:1532-8406
DOI:10.1016/j.arth.2020.02.002