Complications,readmission rates,and in-hospital lengths-of-stay in octogenarian vs. non-octogenarians following total knee arthroplasty: An analysis of over 1.7 million patients |
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| Affiliation: | 1. Maimonides Medical Center, Department of Orthopedic Surgery, Brooklyn, NY, United States;2. State University of New York (SUNY) Downstate, College of Medicine, Brooklyn, NY, United States;1. Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan;2. Center for Cybernics Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan;1. Department of Orthopedics, General Hospital of PLA (People’s Liberation Army), Beijing, PR China;2. Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China;3. Department of Joint Surgery, The Third Hospital of Jinan, Jinan, Shandong, PR China;1. Harrogate and District Foundation Trust, North Yorkshire, England;2. Leeds Beckett University School of Sport, Leeds, England;3. ReSurg SA, Nyon, Switzerland;4. The Duchy Hospital, Harrogate, England;5. West Middlesex Hospital, Isleworth, England;6. Wexham Park Hospital, Slough, England;1. Physical Therapy Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran;2. Physical Therapy Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran;3. Human Motor Control and Computational Neuroscience Lab, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran;4. Exercise Physiology Research Center, Lifestyle Institute, Department of Rheumatology, Baqiyatallah University of Medical Sciences, Tehran, Iran;1. Department of Orthopaedic Surgery, Brigham and Women''s Hospital, 60 Fenwood Road, 2nd Floor, Hale Building for Transformative Medicine, Boston, MA 02115, USA;2. Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA |
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| Abstract: | IntroductionStudies investigating complications between octogenarians and non-octogenarians undergoing primary total knee arthroplasty (TKA) are limited. Therefore, we investigated whether octogenarians are at greater odds of: (1) in-hospital lengths of stay (LOS) (2) readmission rates, (3) medical complications, and (4) hardware complications compared to non-octogenarians following TKA.MethodsA retrospective query of the PearlDiver database isolated 1,775,460 patients who underwent primary TKA from 2005 to 2014. Patients aged 80 and above represented the study cohort (n = 295,908) and patients 65 to 79 represented the control cohort (n = 1,479,552). Study group patients were matched to controls in a 1:5 ratio according to gender and medical comorbidities. Pearson’s Chi Square and logistic regression were used to analyze the primary outcomes of the study which included 90-day medical complications, 90-day readmission rates, 2-year implant-related complications, and in-hospital LOS. A p-value less than 0.001 was statistically significant.ResultsOctogenarians were found to have significantly higher incidence and odds of 90-day readmission rates (10.59 vs. 9.35%; OR: 1.15, p < 0.0001) and significantly longer in-hospital LOS (3.69 days ± 1.95 vs. 3.23 days ± 1.83, p < 0.0001) compared to controls. Octogenarians also had equal incidence and odds of developing any medical complication (1.26 vs. 1.26%; OR: 0.99, p = 0.99) and lower incidence and odds (1.67 vs. 1.93%; OR: 0.86, p < 0.001) of implant-related complications compared to controls.ConclusionOctogenarians undergoing primary TKA have similar odds of medical related complications and lower odds of implant-related complications compared to non-octogenarian patients, whereas readmission rates and in-hospital LOS are greater. |
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| Keywords: | Total knee arthroplasty Octogenarians Length of stay Complications Readmissions Knee |
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