Disparities in Knee and Hip Arthroplasty Outcomes: an Observational Analysis of the ACS-NSQIP Clinical Registry.
Disparities in Knee and Hip Arthroplasty Outcomes: an Observational Analysis of the ACS-NSQIP Clinical Registry.
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膝关节和髋关节置换术结果的差异：ACS-NSQIP 临床登记的观察分析。
DOI：
10.1007/s40615-017-0352-2
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发表时间：
2018-03
影响因子：
3.9
通讯作者：
Jackson T
中科院分区：
文献类型：
--
作者：
Cram P;Hawker G;Matelski J;Ravi B;Pugely A;Gandhi R;Jackson T
全关节置换术 (TJA) 的差异主要通过单中心研究和使用管理数据进行研究。我们的目标是利用大型国际登记系统来调查白人男性、黑人男性、白人女性和黑人女性 TJA 结果的差异。我们使用 ACS-NSQIP 2010-2013 年的数据来确定接受初次全膝关节置换术 (TKA) 或全髋关节置换术 (THA) 的四组成年人（白人男性、黑人男性、白人女性、黑人女性）。我们比较了以下方面的差异：1）手术并发症（死亡、肺栓塞、伤口感染、脓毒症、需要输血的失血、心肌梗塞、肺炎、急性肾衰竭以及代表一种或多种不良结果发生的复合症状）； 2）出院到疗养院。我们确定了 62,075 名 TKA 患者和 39,334 名 THA 患者。 TKA 患者中，白人男性占 35.3%，白人女性占 57.2%，黑人男性占 1.9%，黑人女性占 5.6%。与男性相比，白人和黑人女性明显更有可能经历我们的综合结果（白人女性和白人男性分别为 16.5% 和 14.1%；P<.001）（黑人女性和黑人男性分别为 18.3% 和 14.3%；P=.002）；女性并发症较多的原因是女性输血率较高（白人女性和男性为 14.9% vs 12.2%，黑人为 16.4% vs 11.7%；两者 P<.001）。对于 TKA，黑人（与白人相比）和女性（与男性相比）出院前往疗养院的可能性明显更高。 THA 的结果相似。与之前的研究相比，我们发现白人和黑人男性和女性的原发性 TJA 后并发症大致相似，但两个种族群体女性的输血率明显较高。
Disparities in total joint arthroplasty (TJA) have largely been studied in single center studies and using administrative data. Our objective was to investigate differences in TJA outcomes in white men, black men, white women, and black women using a large international registry. We used 2010–2013 data from the ACS-NSQIP to identify four groups of adults (white men, black men, white women, black women) who underwent primary total knee arthroplasty (TKA) or total hip arthroplasty (THA). We compared differences in: 1) surgical complications (mortality, pulmonary embolism, wound infection, sepsis, blood loss requiring transfusion, myocardial infarction, pneumonia, acute renal failure, and a composite representing occurrence of one-or-more adverse outcomes); 2) discharge to a nursing home. We identified 62,075 TKA and 39,334 THA patients. For TKA 35.3% were white men, 57.2% white women, 1.9% black men, and 5.6% black women. White and black women were significantly more likely to experience our composite outcome when compared to their male counterparts (16.5% and 14.1% for white women and white men; P<.001) (18.3% and 14.3% for black women and black men; P=.002); higher complications for women were explained by higher transfusion rates in women (14.9% vs 12.2% for white women and men, 16.4% vs 11.7% for black; P<.001 for both). For TKA blacks (compared to whites) and women (compared to men) were significantly more likely to be discharged to a nursing home. Results were similar for THA. In contrast to prior studies, we found that complications after primary TJA were generally similar among white and black men and women with the exception of markedly higher transfusion rates among women of both racial groups.
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影响因子：
3
作者：
Cooke CR;Nallamothu B;Kahn JM;Birkmeyer JD;Iwashyna TJ
通讯作者：
Iwashyna TJ
影响因子：
5.3
作者：
Bozic, Kevin J.;Grosso, Laura M.;Drye, Elizabeth E.
通讯作者：
Drye, Elizabeth E.
影响因子：
39.2
作者：
Carson, Jeffrey L.;Grossman, Brenda J.;Djulbegovic, Benjamin
通讯作者：
Djulbegovic, Benjamin
影响因子：
4.7
作者：
Borkhoff, Cornelia M.;Hawker, Gillian A.;Wright, James G.
通讯作者：
Wright, James G.
影响因子：
2.8
作者：
Mota RE;Tarricone R;Ciani O;Bridges JF;Drummond M
通讯作者：
Drummond M