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Complications after hip arthroplasty and the association with hospital procedure volume: A nationwide retrospective cohort study on 50,080 total hip replacements with a follow-up of 3 months after surgery

BACKGROUND AND PURPOSE: It has been suggested that a higher procedure volume is associated with less complications after hip arthroplasty. In order to investigate the incidence of serious negative outcomes and a possible association with procedure volume, we performed a retrospective nationwide coho...

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Autores principales: de Vries, Laura M, Sturkenboom, Miriam CJM, Verhaar, Jan AN, Kingma, J Herre, Stricker, Bruno HCh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Informa Healthcare 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3242950/
https://www.ncbi.nlm.nih.gov/pubmed/21895498
http://dx.doi.org/10.3109/17453674.2011.618907
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author de Vries, Laura M
Sturkenboom, Miriam CJM
Verhaar, Jan AN
Kingma, J Herre
Stricker, Bruno HCh
author_facet de Vries, Laura M
Sturkenboom, Miriam CJM
Verhaar, Jan AN
Kingma, J Herre
Stricker, Bruno HCh
author_sort de Vries, Laura M
collection PubMed
description BACKGROUND AND PURPOSE: It has been suggested that a higher procedure volume is associated with less complications after hip arthroplasty. In order to investigate the incidence of serious negative outcomes and a possible association with procedure volume, we performed a retrospective nationwide cohort study on total hip replacements in all Dutch hospitals. METHODS: All total hip replacements (n = 50,080) that were identified as primary intervention in all general and university medical centers between January 1, 2002 and October 1, 2004 were included. Primary endpoints of follow-up were mortality and complications during admission, and re-admission within 3 months due to complications. Variables that were assessed as potential risk factor were age, sex, duration of (preoperative) admission, specific diagnosis, acute/non-planned admission, co-morbidity, and hospital procedure volume. RESULTS: Age, sex, and comorbidity were associated with complications and mortality. Additionally, acute admission was a risk factor for mortality but not for complications. There was no linear trend indicating that decreasing volume led to an increasing number of complications, and no statistically sginificant effect for mortality was found. INTERPRETATION: After adjustment for several risk factors, we found that the hospitals performing most hip procedures every year had fewer complications during index admission, but that they did not have a lower mortality than groups performing fewer procedures. The lack of a linear trend may be explained by the fact that almost all Dutch hospitals perform a high number of hip arthroplasties each year.
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spelling pubmed-32429502012-01-03 Complications after hip arthroplasty and the association with hospital procedure volume: A nationwide retrospective cohort study on 50,080 total hip replacements with a follow-up of 3 months after surgery de Vries, Laura M Sturkenboom, Miriam CJM Verhaar, Jan AN Kingma, J Herre Stricker, Bruno HCh Acta Orthop Article BACKGROUND AND PURPOSE: It has been suggested that a higher procedure volume is associated with less complications after hip arthroplasty. In order to investigate the incidence of serious negative outcomes and a possible association with procedure volume, we performed a retrospective nationwide cohort study on total hip replacements in all Dutch hospitals. METHODS: All total hip replacements (n = 50,080) that were identified as primary intervention in all general and university medical centers between January 1, 2002 and October 1, 2004 were included. Primary endpoints of follow-up were mortality and complications during admission, and re-admission within 3 months due to complications. Variables that were assessed as potential risk factor were age, sex, duration of (preoperative) admission, specific diagnosis, acute/non-planned admission, co-morbidity, and hospital procedure volume. RESULTS: Age, sex, and comorbidity were associated with complications and mortality. Additionally, acute admission was a risk factor for mortality but not for complications. There was no linear trend indicating that decreasing volume led to an increasing number of complications, and no statistically sginificant effect for mortality was found. INTERPRETATION: After adjustment for several risk factors, we found that the hospitals performing most hip procedures every year had fewer complications during index admission, but that they did not have a lower mortality than groups performing fewer procedures. The lack of a linear trend may be explained by the fact that almost all Dutch hospitals perform a high number of hip arthroplasties each year. Informa Healthcare 2011-10 2011-11-24 /pmc/articles/PMC3242950/ /pubmed/21895498 http://dx.doi.org/10.3109/17453674.2011.618907 Text en Copyright: © Nordic Orthopaedic Federation http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited.
spellingShingle Article
de Vries, Laura M
Sturkenboom, Miriam CJM
Verhaar, Jan AN
Kingma, J Herre
Stricker, Bruno HCh
Complications after hip arthroplasty and the association with hospital procedure volume: A nationwide retrospective cohort study on 50,080 total hip replacements with a follow-up of 3 months after surgery
title Complications after hip arthroplasty and the association with hospital procedure volume: A nationwide retrospective cohort study on 50,080 total hip replacements with a follow-up of 3 months after surgery
title_full Complications after hip arthroplasty and the association with hospital procedure volume: A nationwide retrospective cohort study on 50,080 total hip replacements with a follow-up of 3 months after surgery
title_fullStr Complications after hip arthroplasty and the association with hospital procedure volume: A nationwide retrospective cohort study on 50,080 total hip replacements with a follow-up of 3 months after surgery
title_full_unstemmed Complications after hip arthroplasty and the association with hospital procedure volume: A nationwide retrospective cohort study on 50,080 total hip replacements with a follow-up of 3 months after surgery
title_short Complications after hip arthroplasty and the association with hospital procedure volume: A nationwide retrospective cohort study on 50,080 total hip replacements with a follow-up of 3 months after surgery
title_sort complications after hip arthroplasty and the association with hospital procedure volume: a nationwide retrospective cohort study on 50,080 total hip replacements with a follow-up of 3 months after surgery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3242950/
https://www.ncbi.nlm.nih.gov/pubmed/21895498
http://dx.doi.org/10.3109/17453674.2011.618907
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