Preoperative risks and outcomes of hip and knee arthroplasty in the veterans health administration1 ☆,
Section snippets
Materials and methods
This study reports on the findings of 6,876 THAs and 11,710 TKAs performed in VA hospitals between October 1991 and September 1997. Data sources included the VA National Surgical Quality Improvement Program (NSQIP) 11, 12, 13, 14, 15 and a set of national inpatient discharge databases, known as the VHA Inpatient Medical SAS datasets 16, 17 that contain details on hospital admissions including admission and discharge dates, diagnostic codes, and surgery and procedure information.
The NSQIP,
Hip replacement
A total of 6,876 THA procedures were identified in the database; 2.6% (n = 180) were for women (Table 2). Several significant differences were noted between males and females in the sample, including age, race, and martial status. Females were older, more often white, and less likely to be married (all P<.05) than males. Risk factors including smoking and alcohol use were higher in the male sample. However, females were more likely to be functionally dependent (based on nurse assessment)
Discussion
This project examined preoperative surgical risks and outcomes for 2 procedures common among men and women (i.e., hip and knee arthroplasty) using prospectively collected quality-improvement data supplemented with inpatient discharge data. Not surprisingly, the presence of comorbid conditions, longer time in the operating room, abnormal laboratory values, and cases considered to be higher risk were associated with increased postoperative LOS and 30-day morbidity. Race was also a significant
Acknowledgements
The authors acknowledge the invaluable input and support of Drs. James Gibbs, Kevin Stroupe, Kwan Hur, Elly Budiman-Mak, Hassan Alissa, and Aqueel Kouser; the programming support of Bharat Thakkar; and the project-management skills of Dolores Ippolito.
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Supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service, as project GEN 97–016.
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The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.