Trends in demographics, comorbidity profiles, in-hospital complications and mortality associated with primary knee arthroplasty.
We analyzed the National Hospital Discharge Survey to elucidate temporal changes in the demographics, comorbidities, hospital stay, in-hospital complications, and mortality of patients undergoing primary total knee arthroplasties (TKAs) in the United States. Three 5-year periods were created (1990-1994, 1995-1999, and 2000-2004), and temporal changes were analyzed. The number of TKAs performed increased by 125% for the 3 periods. The increasing proportion of younger patients was accompanied by a concomitant decrease of Medicare-insured patients. Length of stay decreased from 8.44 to 4.18 days. An increase in the proportion of discharges to long-term and short-term care facilities and in procedures performed in small hospitals was noted. Although the prevalence of procedure-related complications decreased over time, comorbidities increased. Despite a decrease in mortality from the first to the second study period (0.50% vs 0.21%), a slight increase was noticed more recently (0.28%). We identified significant changes in most variables studied.
Department of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY 10021, USA.
Stavros G
SG
Memtsoudis
Alejandro González
AG
Della Valle
Melanie C
MC
Besculides
Licia
L
Gaber
Richard
R
Laskin
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000191:economics / Q000639:trends*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity / Q000639:trends*; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends; D008297:Male; D006278:Medicare / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology* / Q000401:mortality*; D015995:Prevalence; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult