Journal article
The Impact of Frailty on Outcomes Following Primary Total Hip Arthroplasty in Patients of Different Sex and Race: Is Frailty Equitably Detrimental?
The Journal of arthroplasty, Vol.38(9), pp.1668-1675
09/2023
DOI: 10.1016/j.arth.2023.01.054
PMID: 36868329
Abstract
Whether frailty impacts total hip arthroplasty (THA) patients of different races or sex equally is unknown. This study aimed to assess the influence of frailty on outcomes following primary THA in patients of differing race and sex.
This is a retrospective cohort study utilizing a national database (2015-2019) to identify frail (≥2 points on the modified frailty index (mFI)-5) patients undergoing primary THA. One-to-one matching for each frail cohort of interest (race: black, Hispanic, Asian, versus white (non-Hispanic), respectively; and sex: men versus women) was performed to diminish confounding. The 30-day complications and resource utilizations were then compared between cohorts.
There was no difference in the occurrence of at least one complication (p>0.05) among frail patients of differing race. However, frail black patients had increased odds of postoperative transfusion (Odds Ratio (OR):1.34, 95%Confidence Interval (CI):1.02-1.77), deep vein thrombosis (DVT; OR:2.61, 95%CI:1.08-6.27), as well as >2-day hospitalization and non-home discharge (p<0.001). Frail women had higher odds of having at least one complication (OR:1.67, 95%CI:1.47-1.89), non-home discharge, readmission, and reoperation (p<0.05). Contrarily, frail men had higher 30-day cardiac arrest (0.2% vs. 0.0%, p=0.020) and mortality (0.3 vs 0.1%, p=0.002).
Frailty appears to have an overall equitable influence on the occurrence of at least one complication in THA patients of different races, although different rates of some individual, specific complications were identified. For instance, frail black patients experienced increased DVT and transfusion rates relative to their non-Hispanic white counterparts. Contrarily, frail women, relative to frail men, have lower 30-day mortality despite increased complication rates.
Details
- Title: Subtitle
- The Impact of Frailty on Outcomes Following Primary Total Hip Arthroplasty in Patients of Different Sex and Race: Is Frailty Equitably Detrimental?
- Creators
- Jesse Seilern und Aspang - Emory University School of MedicineRyan S. Zamanzadeh - Emory University School of MedicineAndrew M. Schwartz - University of IowaAjay Premkumar - Emory University School of MedicineZaamin B. Hussain - Emory University School of MedicineAdam Boissonneault - Emory University School of MedicineJ. Ryan Martin - Vanderbilt University Medical CenterJacob M. Wilson - Vanderbilt University Medical Center
- Resource Type
- Journal article
- Publication Details
- The Journal of arthroplasty, Vol.38(9), pp.1668-1675
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.arth.2023.01.054
- PMID
- 36868329
- ISSN
- 0883-5403
- eISSN
- 1532-8406
- Language
- English
- Electronic publication date
- 02/28/2023
- Date published
- 09/2023
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984375453702771
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