Table 5.
Adjusted odds ratios for outcomes after total hip or knee replacement, by patient and hospital characteristic and surgeon procedure volume
| Characteristic | Adjusted* odds ratio (95% confidence interval) |
|||||||
|---|---|---|---|---|---|---|---|---|
| Surgical complication during index admission |
Death within 90 d |
Readmission for amputation, fusion or excision within 1 yr |
Readmission for revision arthroplasty within 1 yr |
|||||
| Hip | Knee | Hip | Knee | Hip | Knee | Hip | Knee | |
| Patient age (yr) | 1.02† (1.01–1.02) | 1.02† (1.01–1.03) | 1.11† (1.08–1.13) | 1.11† (1.08–1.14) | 0.99 (0.97–1.01) | 0.96† (0.94–0.98) | 1.00 (0.99–1.01) | 0.96† (0.95–0.97) |
| Patient sex (male v. female) | 1.20† (1.04–1.39) | 1.39† (1.23–1.58) | 2.13† (1.52–2.97) | 2.11† (1.42–3.12) | 1.23 (0.65–2.34) | 1.75† (1.17–2.61) | 0.92 (0.73–1.15) | 1.34† (1.02–1.75) |
| Patient comorbidity (Charlson index v. absent or 0) | ||||||||
| 1 | 1.66† (1.26–2.18) | 1.08 (0.70–1.66) | 1.42 (0.67–3.00) | 1.68 (0.77–3.65) | 1.33 (0.41–4.29) | 2.11† (1.01–4.40) | 2.05† (1.35–3.11) | 1.44 (0.75–2.77) |
| ≥ 2 | 1.56† (1.16–2.11) | 1.13 (0.74–1.71) | 3.82† (2.07–7.05) | 3.20† (1.59–6.46) | 2.94 (0.76–11.45) | 2.05 (0.90–4.66) | 1.13 (0.53–2.38) | 1.54 (0.72–3.31) |
| Patient’s arthritis type (rheumatoid v. other) | 0.99 (0.84–1.17) | 1.04 (0.87–1.24) | 1.57 (0.89–2.77) | 1.00 (0.60–1.67) | 0.85 (0.44–1.66) | 0.85 (0.50–1.44) | 1.11 (0.82–1.51) | 1.08 (0.78–1.50) |
| Hospital teaching status (teaching v. other) | 1.78 (0.91–3.45) | 1.68† (1.11–2.56) | 0.74 (0.41–1.36) | 1.17 (0.85–1.61) | 3.81† (2.12–6.87) | 0.65 (0.35–1.19) | 0.95 (0.59–1.54) | 1.18 (0.83–1.68) |
| Hospital procedure volume (mean no. per yr v. hip 10–110, knee 10–130) | ||||||||
| 111–150, 131–180 | 1.09 (0.68–1.73) | 1.52 (0.98–2.36) | 1.19 (0.76–1.87) | 1.07 (0.72–1.59) | 0.76 (0.33–1.73) | 0.51 (0.20–1.29) | 0.92 (0.60–1.41) | 0.64 (0.39–1.04) |
| 151–225, 181–270 | 1.26 (0.62–2.57) | 1.24 (0.81–1.91) | 0.90 (0.55–1.49) | 1.05 (0.75–1.48) | 0.40† (0.18–0.88) | 0.50† (0.27–0.93) | 0.94 (0.67–1.33) | 0.62† (0.42–0.91) |
| > 225, > 270 | 0.67 (0.34–1.30) | 0.97 (0.63–1.50) | 1.22 (0.53–2.78) | 0.69 (0.39–1.23) | 0.76 (0.24–2.40) | 0.69 (0.33–1.44) | 1.34 (0.71–2.52) | 0.50† (0.34–0.72) |
| Surgeon procedure volume (mean no. per yr v. hip 2–25, knee 2–35) | ||||||||
| 26–40, 36–50 | 0.73† (0.60–0.87) | 1.30† (1.05–1.60) | 0.72 (0.47–1.09) | 0.76 (0.53–1.09) | 1.33 (0.61–2.90) | 0.54† (0.33–0.88) | 0.72† (0.54–0.96) | 0.73 (0.53–1.01) |
| 41–60, 51–70 | 0.75† (0.63–0.90) | 1.03 (0.87–1.24) | 0.79 (0.48–1.29) | 0.75 (0.48–1.16) | 0.56 (0.21–1.49) | 0.73 (0.43–1.24) | 0.80 (0.58–1.10) | 0.92 (0.65–1.31) |
| > 60, > 70 | 0.67† (0.55–0.82) | 0.90 (0.67–1.19) | 1.00 (0.52–1.93) | 1.02 (0.63–1.67) | 0.62 (0.37–1.06) | 0.81 (0.41–1.62) | 0.58† (0.42–0.79) | 0.75 (0.51–1.09) |
*
Adjusted for patient age, sex, comorbidity and arthritis type, hospital teaching status, hospital procedure volume, and surgeon procedure volume.
†
Significant at p < 0.05.