Development of a preliminary index that predicts adverse events after total knee replacement

Arthritis and Rheumatism
Daniel H SolomonJeffrey N Katz

Abstract

We undertook this study to assess the relationships between hospital characteristics, volume of procedures, and perioperative outcomes after total knee replacement (TKR), and to use this information to construct a simple predictive index for perioperative outcomes that incorporates hospital- and patient-level characteristics. We studied Medicare beneficiaries who underwent TKR in 4 US states in 2000. Orthopedic surgery administrators from hospitals caring for patients in this sample were surveyed about a range of hospital characteristics. The relationships between these hospital characteristics, patient variables, and 90-day postoperative adverse events (including death, pulmonary embolus, pneumonia, deep wound infection, and acute myocardial infarction) were assessed using generalized estimating equations adjusting for hospital volume. These relationships were assessed in low- and high-risk patient groups. Variables from the final multivariate model were used to create an index that was tested against 90-day adverse event rates. Three hundred twenty-seven (3.6%) of the patients undergoing TKR in our sample experienced an adverse event. In the final multivariate regression models, variables that predicted adverse perioperative ...Continue Reading

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Citations

Jun 26, 2010·ANZ Journal of Surgery·Nicholas E MarlowGuy J Maddern
Sep 21, 2015·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Philip J BelmontAndrew J Schoenfeld
Oct 2, 2014·Zeitschrift für Rheumatologie·J PetzoldJ Kriegsmann
Aug 18, 2017·The Journal of Bone and Joint Surgery. American Volume·Dov B MillstoneY Raja Rampersaud
Oct 29, 2013·Revista Brasileira De Ortopedia·Fernando Cury RezendeMário Carneiro
Mar 3, 2010·The Journal of Bone and Joint Surgery. American Volume·Christian OhmannMax Geraedts
Feb 10, 2007·Clinical Orthopaedics and Related Research·Read G PierceDavid S Bradford
Apr 18, 2014·The Journal of Bone and Joint Surgery. American Volume·Kevin J BozicElizabeth E Drye
Sep 9, 2021·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·C M KuglerD Pieper

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