TABLE I.
Findings from Multivariate Models That Characterize the Association Between Race or Ethnicity and Postoperative Outcomes After Total Knee Replacement
| Study | Outcomes Measured | Findings* |
| Collins et al.31 (1999) | Prolonged length of stay† | Prolonged length of stay (nonwhite odds ratio = 1.6; white odds ratio = 1.00 [referent]; p ≤ 0.01) |
| Weaver et al.32 (2003) | 30-day mortality, 30-day morbidity‡, readmission following index procedure, and length of stay | 30-day morbidity (white odds ratio = 0.79 [0.66-0.94] and nonwhite odds ratio = 1.00 [referent]) |
| Length of stay (parameter estimate = –0.14 days for whites; nonwhite odds ratio = 1.00 [referent]; p = 0.0001) | ||
| Feinglass et al.34 (2004) | Inpatient complication§, discharge to skilled nursing home or rehabilitation hospital, and mean length of stay | Inpatient complication (black odds ratio = 1.00 [0.9-1.1] for a zip code area with a black population of >50%, and black odds ratio = 1.00 [referent] for a zip code area with a black population of <50%; p = 0.92) |
| Ibrahim et al.30 (2005) | 30-day mortality, 30-day non-infection-related complication, and 30-day infection-related complication | 30-day non-infection-related complication (black relative risk = 1.50 [1.08-2.10], Hispanic relative risk = 1.10 [0.62-1.95], and white relative risk = 1.00 [referent]) |
| 30-day infection-related complication (black relative risk = 1.42 [1.06-1.90], Hispanic relative risk = 1.64 [1.08-2.49], and white relative risk = 1.00 [referent]) | ||
| Mahomed et al.26 (2005) | 90-day mortality, 90-day manipulation, 90-day pulmonary embolus, 90-day deep wound infection, and 90-day non-infection-related complication | Mortality (black odds ratio = 1.4 [1.0-1.8] and white odds ratio = 1.00 [referent]) |
| Deep wound infection (black odds ratio = 1.5 [1.0-2.1] and white odds ratio = 1.00 [referent]) | ||
| Postoperative manipulation (black odds ratio = 1.4 [1.2-1.7] and white odds ratio = 1.00 [referent]) | ||
| SooHoo et al.36 (2006) | 90-day mortality, 90-day readmission due to infection, and 90-day readmission due to pulmonary embolism | Mortality (black odds ratio = 0.98 (0.74-1.29), Hispanic odds ratio = 0.90 (0.73-1.11), and white odds ratio = 1.00 [referent]) |
| Infection (black odds ratio = 1.15 [0.90-1.47], Hispanic odds ratio = 1.21 [1.03-1.43], and white odds ratio = 1.00 [referent]) | ||
| Pulmonary embolism (black odds ratio = 1.74 [1.36-2.23], Hispanic odds ratio = 0.84 [0.65-1.09], and white odds ratio = 1.00 [referent]) |
The 95% confidence intervals are given in brackets.
Prolonged length of stay was defined as a postoperative length of stay greater than or equal to the 75th percentile for length of stay.
Thirty-day morbidity included myocardial infarction, pulmonary embolism, and complications, such as urinary tract infection, prolonged ileus, superficial wound infection, and deep vein thrombosis, that were identified by the orthopaedic surgeon.
Inpatient complications included inpatient death, wound infection, iatrogenic complications, pulmonary compromise, acute myocardial infarction, gastrointestinal hemorrhage or ulceration, venous thrombosis or pulmonary embolus, pneumonia after surgery, and/or mechanical complication due to a device, implant, or graft.