Increased Medical Complications,Revisions, In-Hospital Lengths of Stay,and Cost in Patients With Hypogonadism Undergoing Primary Total Knee Arthroplasty |
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| Affiliation: | 1. Department of Orthopaedic Surgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea;2. Department of Orthopedic Surgery, Yeungnam University Medical Center, Daegu, Republic of Korea;3. Department of Orthopaedic Surgery, Chungnam National University Hospital, Daejeon, Republic of Korea;4. Department of Orthopaedic Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea;5. Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea;6. Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505,Republic of Korea |
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| Abstract: | BackgroundResearch regarding the impact of hypogonadism following primary total knee arthroplasty (TKA) is limited. Therefore, the purpose of this study is to investigate whether patients with hypogonadism undergoing primary TKA are at increased odds of (1) medical complications, (2) revisions, (3) in-hospital lengths of stay (LOSs), and (4) cost of care.MethodsA Humana patient population consisting of 8 million lives was retrospectively analyzed from 2007 to 2017 using International Classification of Disease, 9th Revision codes. Patients were filtered by male gender and patients with hypogonadism were matched to controls in a 1:4 ratio according to age and medical comorbidities. The query yielded 8393 patients with (n = 1681) and without (6712) hypogonadism undergoing primary TKA. Primary outcomes analyzed included medical complications, revision rates, in-hospital LOS, and cost of care. Logistic regression analysis was used to calculate odds ratios (OR) of 90-day medical complications and 2-year revisions. Welch’s t-test was used to test for significance in LOS and cost of care between cohorts. A P-value less than .05 was considered statistically significant.ResultsHypogonadal patients undergoing primary TKA were found to have increased incidence and odds (9.45% vs 4.67%; OR 2.12, P < .0001) of developing 90-day medical complications. Hypogonadal patients undergoing primary TKA were found to have a greater incidence and odds (3.99% vs 2.80%; OR 1.89, P < .0001) of 2-year revisions. Hypogonadal patients had a 6.11% longer LOS (3.47 vs 3.27 days, P = .02) compared to controls, and incurred greater 90-day costs ($15,564.31 vs $14,856.69, P = .018) compared to controls.ConclusionThis analysis of over 1600 patients demonstrates that patients with hypogonadism undergoing primary TKA have greater odds of postoperative medical complications, revisions, increased LOS, and cost of care. |
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| Keywords: | total knee arthroplasty hypogonadism complications Humana cost |
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