Journal article
The Effect of Advancing Age on Total Joint Replacement Outcomes
Geriatric orthopaedic surgery & rehabilitation, Vol.6(3), pp.173-179
09/2015
DOI: 10.1177/2151458515583515
PMCID: PMC4536505
PMID: 26328232
Abstract
Objective: To describe age-related differences in outcomes among older adults undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA).
Design: Retrospective study.
Participants: A total of 1792 patients who underwent primary THA or TKA at the University of Iowa Hospitals and Clinics between 2010 and 2013 were identified in the University HealthSystem Consortium Database and University of Iowa Orthopedics Joint Replacement Registry.
Main outcome measures: Hospital length of stay (LOS), 30-day readmission rate, in-hospital mortality, number of days admitted to intensive care unit (ICU discharge disposition), in-hospital complications (pulmonary embolism, deep vein thrombosis, wound infection, hemorrhage, sepsis, or myocardial infarction), quality of life (measured using Short-Form 36 [SF-36]), discharge disposition (home, home with home health, nursing home, inpatient rehabilitation, transfer to another acute care hospital, and dead), and total patient level observed hospital cost (based on hospital charge information from each revenue code and estimated labor costs). Outcomes were compared in patients stratified by age and categorized by decade (ie, ≤50, 51-60, 61-70, 71-80, and ≥81).
Results: A total of 871 THAs and 921 TKAs were performed. The mean age of our cohort was 60.5 years and 56.1% were women. In-hospital complication rates and ICU utilization progressively increased with increasing age. There was also a higher likelihood of skilled nursing facility placement and longer LOS. There was no increase in 30-day readmissions, mortality, or total cost. Improvements in patient reported outcomes (SF-36) scores were similar for all age-groups.
Conclusions: Compared to younger patients, older THA and TKA recipients were more likely to experience postoperative complications, admission to the ICU, discharge to a skilled care facility, and had longer hospital LOS. Improvements in patient-related outcomes were similar across all age-groups. These findings may be helpful when counseling older patients regarding elective total joint arthroplasty.
Details
- Title: Subtitle
- The Effect of Advancing Age on Total Joint Replacement Outcomes
- Creators
- Michele Fang - Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USANicolas Noiseux - Division of Orthopedic Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USAEric Linson - Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USAPeter Cram - Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
- Resource Type
- Journal article
- Publication Details
- Geriatric orthopaedic surgery & rehabilitation, Vol.6(3), pp.173-179
- Publisher
- SAGE Publications; Sage CA: Los Angeles, CA
- DOI
- 10.1177/2151458515583515
- PMID
- 26328232
- PMCID
- PMC4536505
- ISSN
- 2151-4585
- eISSN
- 2151-4593
- Language
- English
- Date published
- 09/2015
- Academic Unit
- Orthopedics and Rehabilitation; Internal Medicine
- Record Identifier
- 9984040255802771
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