Total Elbow Arthroplasty in the United States: Evaluation of Cost, Patient Demographics, and Complication Rates
Authors
Zhou, HanbingOrvets, Nathan D.
Merlin, Gabriel
Shaw, Joshua J.
Dines, Joshua S.
Price, Mark D.
Eichinger, Josef K.
Li, Xinning
UMass Chan Affiliations
Department of Orthopedic Surgery, University of Massachusetts Medical CenterDocument Type
Journal ArticlePublication Date
2016-03-31Keywords
Total elbow arthroplastyUnited States
complications
in-patient trend
insurance
readmission
Clinical Epidemiology
Epidemiology
Health Services Administration
Orthopedics
Surgery
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Show full item recordAbstract
Total elbow arthroplasty (TEA) is utilized in the treatment of rheumatoid and post-traumatic elbow arthritis. TEA is a relatively low volume surgery in comparison to other types of arthroplasty and therefore little is known about current surgical utilization, patient demographics and complication rates in the United States. The purpose of our study is to evaluate the current practice trends and associated in-patient complications of TEA at academic centers in the United States. We queried the University Health Systems Consortium administrative database from 2007 to 2011 for patients who underwent an elective TEA. A descriptive analysis of demographics was performed which included patient age, sex, race, and insurance status. We also evaluated the following patient clinical benchmarks: hospital length of stay (LOS), hospital direct cost, in-hospital mortality, complications, and 30-day readmission rates. Our cohort consisted of 3146 adult patients (36.5% male and 63.5% female) with an average age of 58 years who underwent a total elbow arthroplasty (159 academic medical centers) in the United States. The racial demographics included 2334 (74%) Caucasian, 285 (9%) black, 236 (7.5%) Hispanic, 16 (0.5%) Asian, and 283 (9%) other patients. The mean LOS was 4.2+/-5 days and the mean total direct cost for the hospital was 16,300+/-4000 US Dollars per case. The overall inpatient complication rate was 3.1% and included mortality < 1%, DVT (0.8%), re-operation (0.5%), and infection (0.4%). The 30-day readmission rate was 4.4%. TEA is a relatively uncommon surgery in comparison to other forms of arthroplasty but is associated with low in-patient and 30-day perioperative complication rate. Additionally, the 30-day readmission rate and overall hospital costs are comparable to the traditional total hip and knee arthroplasty surgeries.Source
Orthop Rev (Pavia). 2016 Mar 31;8(1):6113. doi: 10.4081/or.2016.6113. eCollection 2016. Link to article on publisher's siteDOI
10.4081/or.2016.6113Permanent Link to this Item
http://hdl.handle.net/20.500.14038/40074PubMed ID
27114806Related Resources
Link to Article in PubMedDistribution License
http://creativecommons.org/licenses/by-nc/4.0/ae974a485f413a2113503eed53cd6c53
10.4081/or.2016.6113
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Except where otherwise noted, this item's license is described as http://creativecommons.org/licenses/by-nc/4.0/