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Personalized estimation of one-year mortality risk after elective hip or knee arthroplasty for osteoarthritis: JointCalc model development and validation using the National Joint Registry and the Norwegian Arthroplasty Register
AIMS: To develop and validate patient-centred algorithms that estimate individual risk of death over the first year after elective joint arthroplasty surgery for osteoarthritis. METHODS: A total of 763,213 hip and knee joint arthroplasty episodes recorded in the National Joint Registry for England a...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The British Editorial Society of Bone & Joint Surgery
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7672327/ https://www.ncbi.nlm.nih.gov/pubmed/33179531 http://dx.doi.org/10.1302/2046-3758.911.BJR-2020-0343.R1 |
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author | Trela-Larsen, Lea Kroken, Gard Bartz-Johannessen, Christoffer Sayers, Adrian Aram, Parham McCloskey, Eugene Kadirkamanathan, Visakan Blom, Ashley W. Lie, Stein Atle Furnes, Ove Nord Wilkinson, J. Mark |
author_facet | Trela-Larsen, Lea Kroken, Gard Bartz-Johannessen, Christoffer Sayers, Adrian Aram, Parham McCloskey, Eugene Kadirkamanathan, Visakan Blom, Ashley W. Lie, Stein Atle Furnes, Ove Nord Wilkinson, J. Mark |
author_sort | Trela-Larsen, Lea |
collection | PubMed |
description | AIMS: To develop and validate patient-centred algorithms that estimate individual risk of death over the first year after elective joint arthroplasty surgery for osteoarthritis. METHODS: A total of 763,213 hip and knee joint arthroplasty episodes recorded in the National Joint Registry for England and Wales (NJR) and 105,407 episodes from the Norwegian Arthroplasty Register were used to model individual mortality risk over the first year after surgery using flexible parametric survival regression. RESULTS: The one-year mortality rates in the NJR were 10.8 and 8.9 per 1,000 patient-years after hip and knee arthroplasty, respectively. The Norwegian mortality rates were 9.1 and 6.0 per 1,000 patient-years, respectively. The strongest predictors of death in the final models were age, sex, body mass index, and American Society of Anesthesiologists grade. Exposure variables related to the intervention, with the exception of knee arthroplasty type, did not add discrimination over patient factors alone. Discrimination was good in both cohorts, with c-indices above 0.76 for the hip and above 0.70 for the knee. Time-dependent Brier scores indicated appropriate estimation of the mortality rate (≤ 0.01, all models). CONCLUSION: Simple demographic and clinical information may be used to calculate an individualized estimation for one-year mortality risk after hip or knee arthroplasty (https://jointcalc.shef.ac.uk). These models may be used to provide patients with an estimate of the risk of mortality after joint arthroplasty. Cite this article: Bone Joint Res 2020;9(11):808–820. |
format | Online Article Text |
id | pubmed-7672327 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | The British Editorial Society of Bone & Joint Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-76723272020-11-19 Personalized estimation of one-year mortality risk after elective hip or knee arthroplasty for osteoarthritis: JointCalc model development and validation using the National Joint Registry and the Norwegian Arthroplasty Register Trela-Larsen, Lea Kroken, Gard Bartz-Johannessen, Christoffer Sayers, Adrian Aram, Parham McCloskey, Eugene Kadirkamanathan, Visakan Blom, Ashley W. Lie, Stein Atle Furnes, Ove Nord Wilkinson, J. Mark Bone Joint Res Arthroplasty AIMS: To develop and validate patient-centred algorithms that estimate individual risk of death over the first year after elective joint arthroplasty surgery for osteoarthritis. METHODS: A total of 763,213 hip and knee joint arthroplasty episodes recorded in the National Joint Registry for England and Wales (NJR) and 105,407 episodes from the Norwegian Arthroplasty Register were used to model individual mortality risk over the first year after surgery using flexible parametric survival regression. RESULTS: The one-year mortality rates in the NJR were 10.8 and 8.9 per 1,000 patient-years after hip and knee arthroplasty, respectively. The Norwegian mortality rates were 9.1 and 6.0 per 1,000 patient-years, respectively. The strongest predictors of death in the final models were age, sex, body mass index, and American Society of Anesthesiologists grade. Exposure variables related to the intervention, with the exception of knee arthroplasty type, did not add discrimination over patient factors alone. Discrimination was good in both cohorts, with c-indices above 0.76 for the hip and above 0.70 for the knee. Time-dependent Brier scores indicated appropriate estimation of the mortality rate (≤ 0.01, all models). CONCLUSION: Simple demographic and clinical information may be used to calculate an individualized estimation for one-year mortality risk after hip or knee arthroplasty (https://jointcalc.shef.ac.uk). These models may be used to provide patients with an estimate of the risk of mortality after joint arthroplasty. Cite this article: Bone Joint Res 2020;9(11):808–820. The British Editorial Society of Bone & Joint Surgery 2020-11-12 /pmc/articles/PMC7672327/ /pubmed/33179531 http://dx.doi.org/10.1302/2046-3758.911.BJR-2020-0343.R1 Text en © 2020 Author(s) et al. https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/. |
spellingShingle | Arthroplasty Trela-Larsen, Lea Kroken, Gard Bartz-Johannessen, Christoffer Sayers, Adrian Aram, Parham McCloskey, Eugene Kadirkamanathan, Visakan Blom, Ashley W. Lie, Stein Atle Furnes, Ove Nord Wilkinson, J. Mark Personalized estimation of one-year mortality risk after elective hip or knee arthroplasty for osteoarthritis: JointCalc model development and validation using the National Joint Registry and the Norwegian Arthroplasty Register |
title | Personalized estimation of one-year mortality risk after elective hip or knee arthroplasty for osteoarthritis: JointCalc model development and validation using the National Joint Registry and the Norwegian Arthroplasty Register |
title_full | Personalized estimation of one-year mortality risk after elective hip or knee arthroplasty for osteoarthritis: JointCalc model development and validation using the National Joint Registry and the Norwegian Arthroplasty Register |
title_fullStr | Personalized estimation of one-year mortality risk after elective hip or knee arthroplasty for osteoarthritis: JointCalc model development and validation using the National Joint Registry and the Norwegian Arthroplasty Register |
title_full_unstemmed | Personalized estimation of one-year mortality risk after elective hip or knee arthroplasty for osteoarthritis: JointCalc model development and validation using the National Joint Registry and the Norwegian Arthroplasty Register |
title_short | Personalized estimation of one-year mortality risk after elective hip or knee arthroplasty for osteoarthritis: JointCalc model development and validation using the National Joint Registry and the Norwegian Arthroplasty Register |
title_sort | personalized estimation of one-year mortality risk after elective hip or knee arthroplasty for osteoarthritis: jointcalc model development and validation using the national joint registry and the norwegian arthroplasty register |
topic | Arthroplasty |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7672327/ https://www.ncbi.nlm.nih.gov/pubmed/33179531 http://dx.doi.org/10.1302/2046-3758.911.BJR-2020-0343.R1 |
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