title: Can Administrative Data Be Used to Analyze Complications Following Total Joint Arthroplasty?
abstract: We hypothesized that the Centers for Medicare and Medicaid Services Limited Dataset (CMS-LDS) could be used to validate the complications associated with total hip and knee arthroplasty (THA and TKA) endorsed by the Hip and Knee Societies. Using ICD-9 procedure and diagnosis codes, cases were extracted from the first three quarters of the 2009 CMS-LDS to allow all complications within 90-days be captured in the same calendar year. We were unable to validate the Hip and Knee Societies' complications as we could not connect readmissions or outpatient visits to index admissions. In addition, well-known complications were not detected, raising concerns about coding accuracy and stratification. Furthermore, the assignment of outpatient and inpatient codes allows for duplication of complications which may falsely elevate the true incidence.
authors.affiliation: Department of Orthopaedic Surgery, NYU Langone Medical Center, Hospital for Joint Diseases, New York, New York.
authors.forename: Andrew James
authors.initials: AJ
authors.lastname: Clair
authors.affiliation: Department of Orthopaedic Surgery, NYU Langone Medical Center, Hospital for Joint Diseases, New York, New York.
authors.forename: Ifeoma A
authors.initials: IA
authors.lastname: Inneh
authors.affiliation: Department of Orthopaedic Surgery, NYU Langone Medical Center, Hospital for Joint Diseases, New York, New York.
authors.forename: Richard
authors.initials: R
authors.lastname: Iorio
authors.affiliation: Joint Implant Surgeons, Inc., New Albany, Ohio.
authors.forename: Keith R
authors.initials: KR
authors.lastname: Berend
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois.
authors.forename: Craig J
authors.initials: CJ
authors.lastname: Della Valle
authors.affiliation: Kaplan Joint Center, Newton Wellesley Hospital, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: William L
authors.initials: WL
authors.lastname: Healy
authors.affiliation: Department of Orthopaedics, Medical University of South Carolina, Charleston, South Carolina; Musculoskeletal Service Line, Medical University Hospital Authority, Charleston, South Carolina.
authors.forename: Vincent D
authors.initials: VD
authors.lastname: Pelligrini
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000706:statistics & numerical data; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000706:statistics & numerical data; D014487:Centers for Medicare and Medicaid Services, U.S.; D003625:Data Collection; D003627:Data Interpretation, Statistical; D016208:Databases, Factual; D006801:Humans; D007297:Inpatients; D006278:Medicare / Q000706:statistics & numerical data; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D016896:Treatment Outcome; D014481:United States
keywords: administrative data; complications; healthcare quality; total hip arthroplasty; total knee arthroplasty