Journal article
Total Joint Arthroplasty in Patients With Schizophrenia: How Much Does It Increase the Risk of Complications?
The Journal of arthroplasty, Vol.33(7), pp.2082-2086
07/2018
DOI: 10.1016/j.arth.2018.01.074
PMID: 29526332
Abstract
Mental illness is an often overlooked comorbidity in the total joint arthroplasty (TJA) population. The purpose of this study was to evaluate the risk of schizophrenia on the outcomes of TJA.
The nationwide inpatient sample was used to identify a cohort of 505,840 patients having total hip arthroplasty between 2009 and 2012, of which 953 patients (0.2%) had been diagnosed with schizophrenia. Multivariate logistic regression was used to identify the impact of schizophrenia on short-term medical and surgical complications. Differences in length of stay and discharge disposition were also compared.
Schizophrenic patients are 15 times more likely to have pulmonary insufficiency after surgery (odds ratio [OR] 15.1, P = .0133). Patients were 11 times more likely to have mental status changes (OR 11.1, P = .0002), 3 times more likely to have a mechanical complication of the implant (OR 3.2, P = .0031), and 2 times more likely to require a transfusion (OR 2.4, P < .0001). All-cause medical (OR 2.2, P < .0001) and surgical (OR 1.5, P < .0001) complications were higher in schizophrenic patients. Patients stayed 0.63 days longer in the hospital (P < .0001), and were 3 times more likely to discharge to a facility (OR 2.7, P < .0001).
TJA in patients with schizophrenia had markedly increased complications. Particularly, pulmonary complications, mechanical complications of the implant, mental status changes, and transfusion rates were higher. Future risk adjustment models should include schizophrenia as a major contributor to increased complications.
Details
- Title: Subtitle
- Total Joint Arthroplasty in Patients With Schizophrenia: How Much Does It Increase the Risk of Complications?
- Creators
- J Joseph Gholson - Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IANicholas A Bedard - Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IAS Blake Dowdle - Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IATimothy S Brown - Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IAYubo Gao - Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IAJohn J Callaghan - Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA
- Resource Type
- Journal article
- Publication Details
- The Journal of arthroplasty, Vol.33(7), pp.2082-2086
- Publisher
- United States
- DOI
- 10.1016/j.arth.2018.01.074
- PMID
- 29526332
- ISSN
- 0883-5403
- eISSN
- 1532-8406
- Language
- English
- Date published
- 07/2018
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Internal Medicine
- Record Identifier
- 9984040012702771
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