PMID- 33124004
OWN - NLM
STAT- MEDLINE
DCOM- 20220131
LR  - 20220131
IS  - 2196-8837 (Electronic)
IS  - 2196-8837 (Linking)
VI  - 8
IP  - 6
DP  - 2021 Dec
TI  - Time Trends in Perioperative Characteristics and Health Outcomes in Hispanic 
      Patients Undergoing Primary Total Knee Arthroplasty.
PG  - 1475-1481
LID - 10.1007/s40615-020-00910-8 [doi]
AB  - OBJECTIVE: This study analyzed the yearly trends in procedure utilization, 
      comorbidity profiles, hospital length of stay (LOS), and 30-day outcomes in 
      Hispanic/Latino patients undergoing primary total knee arthroplasty (TKA). Risk 
      stratification for the development of postsurgical adverse events (AEs) was also 
      investigated. METHODS: The American College of Surgeons National Surgical Quality 
      Improvement Program (ACS-NSQIP) was queried for all Hispanic/Latino patients who 
      underwent primary, elective TKA between 2011 and 2017. Thirty-day outcomes and 
      risk factors were determined using multivariate models that controlled for 
      baseline and perioperative differences. RESULTS: A total of 12,767 
      Hispanic/Latino patients were identified. Over the study period, the rate of TKA 
      utilization increased by 108%. During the same time, there were significant 
      reductions in the rates of COPD (1.9% vs. 2.9%, p = 0.015), anemia (18.0% vs. 
      23.5%, p < 0.001), dyspnea (2.9% vs. 4.0%, p = 0.006), and procedure length 
      > 100 min (35.2% vs. 39.4%, p < 0.001). Postoperatively, there was a significant 
      decrease in LOS > 2 days (41.3% vs. 75.6%, p < 0.001), but there was an increase 
      in the rate of developing 30-day AEs (5.8% vs. 4.7%, p = 0.046). Independent risk 
      factors for 30-day AEs included age > 65 years, male sex, chronic steroid use, 
      ASA > 2, diabetes, bleeding disorder, chronic kidney disease, and procedure 
      length > 100 min. CONCLUSION: While the recent trends in procedure utilization, 
      comorbidity profiles, and LOS in Hispanic/Latino patients undergoing primary TKA 
      are reassuring, these have not been accompanied with improved postoperative 
      safety. Patients with bleeding disorders, chronic steroid use, and those admitted 
      from facilities other than home appear to be at highest risk for developing 
      30-day AEs.
CI  - (c) 2020. W. Montague Cobb-NMA Health Institute.
FAU - Venugopal, Vivek
AU  - Venugopal V
AD  - Department of Orthopaedic Surgery, Baylor College of Medicine, 7200 Cambridge 
      Street, Suite 10A, Houston, TX, 77030, USA.
FAU - Gronbeck, Christian
AU  - Gronbeck C
AD  - University of Connecticut School of Medicine, Farmington, CT, USA.
FAU - Harvey, Lucas
AU  - Harvey L
AD  - Department of Orthopaedic Surgery, Baylor College of Medicine, 7200 Cambridge 
      Street, Suite 10A, Houston, TX, 77030, USA.
FAU - Patel, Aalok P
AU  - Patel AP
AD  - Department of Orthopaedic Surgery, Baylor College of Medicine, 7200 Cambridge 
      Street, Suite 10A, Houston, TX, 77030, USA.
FAU - Harrington, Melvyn A
AU  - Harrington MA
AD  - Department of Orthopaedic Surgery, Baylor College of Medicine, 7200 Cambridge 
      Street, Suite 10A, Houston, TX, 77030, USA.
FAU - Halawi, Mohamad J
AU  - Halawi MJ
AD  - Department of Orthopaedic Surgery, Baylor College of Medicine, 7200 Cambridge 
      Street, Suite 10A, Houston, TX, 77030, USA. mohamad.halawi@bcm.edu.
LA  - eng
PT  - Journal Article
DEP - 20201029
PL  - Switzerland
TA  - J Racial Ethn Health Disparities
JT  - Journal of racial and ethnic health disparities
JID - 101628476
SB  - IM
MH  - Aged
MH  - *Arthroplasty, Replacement, Knee
MH  - Hispanic or Latino
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Outcome Assessment, Health Care
MH  - Postoperative Complications/epidemiology
MH  - Retrospective Studies
MH  - Risk Factors
OTO - NOTNLM
OT  - Hispanic
OT  - Latino
OT  - Outcomes
OT  - Time trends, risk factors
OT  - Total knee arthroplasty
EDAT- 2020/10/31 06:00
MHDA- 2022/02/01 06:00
CRDT- 2020/10/30 05:59
PHST- 2020/08/21 00:00 [received]
PHST- 2020/10/23 00:00 [accepted]
PHST- 2020/10/22 00:00 [revised]
PHST- 2020/10/31 06:00 [pubmed]
PHST- 2022/02/01 06:00 [medline]
PHST- 2020/10/30 05:59 [entrez]
AID - 10.1007/s40615-020-00910-8 [pii]
AID - 10.1007/s40615-020-00910-8 [doi]
PST - ppublish
SO  - J Racial Ethn Health Disparities. 2021 Dec;8(6):1475-1481. doi: 
      10.1007/s40615-020-00910-8. Epub 2020 Oct 29.