Evidence map›Paper›PMID 36224453›Full record

ArticleJournal of patient-reported outcomes2022

Association between VTE and antibiotic prophylaxis guideline compliance and patient-reported outcomes after total hip and knee arthroplasty: an observational study.

Helen Badge, Tim Churches, Justine M Naylor, Wei Xuan, Elizabeth Armstrong, Leeanne Gray, John Fletcher, Iain Gosbell, Chung-Wei Christine Lin, Ian A Harris

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In one paragraph

Article in Journal of patient-reported outcomes, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Helen BadgeWhitlam Orthopaedic Research Centre, 1 Campbell Street, Liverpool, 2071, Australia. helen.badgehawke@gmail.com.ORCID http://orcid.org/0000-0002-5351-393X
Tim ChurchesSouth Western Sydney Clinical School, UNSW, 1 Elizabeth Street, Liverpool, 2071, Australia.
Justine M NaylorWhitlam Orthopaedic Research Centre, 1 Campbell Street, Liverpool, 2071, Australia.
Wei XuanSouth Western Sydney Clinical School, UNSW, 1 Elizabeth Street, Liverpool, 2071, Australia.
Elizabeth ArmstrongSchool of Population Health, The University of New South Wales, High St Kensington, Kensington, NSW, 2052, Australia.
Leeanne GraySouth Western Sydney Local Health District, 1 Elizabeth Street, Liverpool, 2071, Australia.
John FletcherUniversity of Sydney, Fisher Road, Camperdown, NSW, 2006, Australia.
Iain GosbellIngham Institute for Applied Medical Research, 1 Campbell Street, Liverpool, 2071, Australia.
Chung-Wei Christine LinSydney School of Public Health, The University of Sydney, Edward Ford Building (A27) Fisher Road, Camperdown, NSW, 2006, Australia.
Ian A HarrisWhitlam Orthopaedic Research Centre, 1 Campbell Street, Liverpool, 2071, Australia.

Funding

HCF Research Foundation IHIIAMR2012073043
6 · The paper itself

Abstract

backgroundSurgical site infection (SSI) and venous thromboembolism (VTE) are associated with high burden and cost and are considered largely preventable following total knee or hip arthroplasty (TKA, THA). The risk of developing VTE and SSI is reduced when prophylaxis is compliant with evidence-based clinical guidelines. However, the association between VTE and antibiotic prophylaxis clinical guideline compliance and patient-reported outcome measures (PROMs) after THA/TKA is unknown. This study aims to explore whether care that is non-compliant with VTE and antibiotic guideline recommendations is associated with PROMs (Oxford Hip/Knee Score and EQ-5D Index scores) at 90- and 365-days after surgery.

methodsThis prospective observational study included high-volume arthroplasty public and private sites and consenting eligible participants undergoing elective primary THA/TKA. We conducted multiple linear regression and linear mixed-effects modelling to explore the associations between non-compliance with VTE and antibiotic guidelines, and PROMs.

resultsThe sample included 1838 participants. Compliance with VTE and antibiotic guidelines was 35% and 13.2% respectively. In adjusted modelling, non-compliance with VTE guidelines was not associated with 90-day Oxford score (β = - 0.54, standard error [SE] = 0.34, p = 0.112) but was significantly associated with lower (worse) 365-day Oxford score (β = - 0.76, SE = 0.29, p = 0.009), lower EQ-5D Index scores at 90- (β = - 0.02 SE = 0.008, p = 0.011) and 365-days (β = - 0.03, SE = 0.008, p = 0.002).. The changes in Oxford and EQ-5D Index scores were not clinically important. Noncompliance with antibiotic guidelines was not associated with either PROM at 90- (Oxford: β = - 0.45, standard error [SE] = 0.47, p = 0.341; EQ-5D: β = - 0.001, SE = 0.011, p = 0.891) or 365-days (Oxford score: β = - 0.06, SE = 0.41, p = 0.880 EQ-5D: β = - 0.010, SE = 0.012, p = 0.383). Results were consistent when complications were included in the model and in linear mixed-effects modelling with the insurance sector as a random effect.

conclusionsNon-compliance with VTE prophylaxis guidelines, but not antibiotic guidelines, is associated with statistically significant but not clinically meaningful differences in Oxford scores and EQ-5D Index scores at 365 days.

Indexed as

ComplicationsPatient-reported outcome measuresPreventionSurgical site infectionTotal hip arthroplastyTotal knee arthroplastyVenous thromboembolism

Identifiers

PMID36224453
PMCPMC9556685

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.