ArticleClinical orthopaedics and related research2014
Is changing hospitals for revision total joint arthroplasty associated with more complications?
Article in Clinical orthopaedics and related research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Impact of centre volume, surgeon volume, surgeon experience and geographic location on reoperation after intramedullary nailing of tibial shaft fracturesCanadian journal of surgery. Journal canadien de chirurgie · 2021Trial
- Evaluation of machine learning models to identify hip arthroplasty implants using transfer learning algorithms.Journal of clinical orthopaedics and trauma · 2023Article
- Association between cumulative surgeon experience and long-term outcomes in complex abdominal wall reconstruction.Hernia : the journal of hernias and abdominal wall surgery · 2023Review
- Automated Detection of Surgical Implants on Plain Knee Radiographs Using a Deep Learning Algorithm.Medicina (Kaunas, Lithuania) · 2022Article
- Artificial Intelligence-Based Solution in Personalized Computer-Aided Arthroscopy of Shoulder Prostheses.Journal of personalized medicine · 2022Article
- Knee Implant Identification by Fine-Tuning Deep Learning Models.Indian journal of orthopaedics · 2021Article
- Artificial Intelligence-Based Recognition of Different Types of Shoulder Implants in X-ray Scans Based on Dense Residual Ensemble-Network for Personalized Medicine.Journal of personalized medicine · 2021Article
- What is the Rate of Revision Discectomies After Primary Discectomy on a National Scale?Clinical orthopaedics and related research · 2017Article
- Application of deep learning algorithm in automated identification of knee arthroplasty implants from plain radiographs using transfer learning models: Are algorithms better than humans?Journal of orthopaedicsArticle
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Authors and funding
6 authors.
Funding
Abstract
backgroundMany patients change hospitals for revision total joint arthroplasty (TJA). The implications of changing hospitals must be better understood to inform appropriate utilization strategies. QUESTIONS/PURPOSES: (1) How frequently do patients change hospitals for revision TJA? (2) Which patient, community, and hospital characteristics are associated with changing hospitals? (3) Is there an increased complication risk after changing hospitals?
methodsWe identified 17,018 patients who underwent primary TJA and subsequent same-joint revision in New York or California (1997-2005) from statewide databases. Medicare was the most common payer (56%) followed by private insurance (31%). We identified patients who changed hospitals for revision TJA and those who experienced in-hospital complications. Patient, community, and hospital characteristics were analyzed to determine predictors for changing hospitals for revision TJA and the effect of changing hospitals on subsequent complications.
resultsThirty percent of patients changed hospitals for revision. Older patients were less likely to change hospitals (odds ratio [OR], 0.84; 95% confidence interval [CI], 0.73-0.96); no other patient characteristics were associated with changing hospitals. Patients who had index TJA at the highest-volume hospitals were less likely to change hospitals (OR, 0.52; 95% CI, 0.48-0.57). Overall, changing hospitals was associated with higher complication risk (OR, 1.19; 95% CI, 1.03-1.39). Changing to a lower-volume hospital (6% of patients undergoing revision TJA) was associated with a higher risk of complications (OR, 1.36; 95% CI, 1.05-1.74). A post hoc number needed-to-treat analysis indicates that 234 patients would need to be moved from a lower volume hospital to a higher volume hospital to avoid one overall complication event after revision TJA.
conclusionsAlthough the complication risk was higher if changing hospitals, this finding was sensitive to the type of change. Our findings build on the existing evidence of a volume-outcomes benefit for revision TJA by examining the effect of volume in view of potential patient migration. LEVEL OF EVIDENCE: Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
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