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Time trends in case-mix and risk of revision following hip and knee arthroplasty in public and private hospitals: a cross-sectional analysis based on 476,312 procedures from the Dutch Arthroplasty Register.
Van Dooren, Bart-Jan; Bos, Pelle; Peters, Rinne M; Van Steenbergen, Liza N; De Visser, Enrico; Brinkman, J Martijn; Schreurs, B Willem; Zijlstra, Wierd P.
Afiliação
  • Van Dooren BJ; Department of Orthopedic Surgery, Medical Center Leeuwarden; Department of Orthopedic Surgery, Martini Hospital, Groningen. Bart.van.dooren@mcl.nl.
  • Bos P; Department of Orthopedic Surgery, Medical Center Leeuwarden.
  • Peters RM; Department of Orthopedic Surgery, Medical Center Leeuwarden; Department of Orthopedic Surgery, Martini Hospital, Groningen.
  • Van Steenbergen LN; Dutch Arthroplasty Register (LROI), 's Hertogenbosch.
  • De Visser E; Department of Orthopedic Surgery, Canisius Wilhelmina Hospital, Nijmegen; Department of Orthopedic Surgery, Kliniek Orthoparc Rozendaal.
  • Brinkman JM; Department of Orthopedic Surgery, Kliniek ViaSana, Mill.
  • Schreurs BW; Dutch Arthroplasty Register (LROI), 's Hertogenbosch; Department of Orthopedic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.
  • Zijlstra WP; Department of Orthopedic Surgery, Medical Center Leeuwarden.
Acta Orthop ; 95: 307-318, 2024 06 17.
Article em En | MEDLINE | ID: mdl-38884413
ABSTRACT
BACKGROUND AND

PURPOSE:

This study aims to assess time trends in case-mix and to evaluate the risk of revision and causes following primary THA, TKA, and UKA in private and public hospitals in the Netherlands.

METHODS:

We retrospectively analyzed 476,312 primary arthroplasties (public n = 413,560 and private n = 62,752) implanted between 2014 and 2023 using Dutch Arthroplasty Register data. We explored patient demographics, procedure details, trends over time, and revisions per hospital type. Adjusted revision risk was calculated for comparable subgroups (ASA I/II, age ≤ 75, BMI ≤ 30, osteoarthritis diagnosis, and moderate-high socioeconomic status (SES).

RESULTS:

The volume of THAs and TKAs in private hospitals increased from 4% and 9% in 2014, to 18% and 21% in 2022. Patients in private hospitals were younger, had lower ASA classification, lower BMI, and higher SES compared with public hospital patients. In private hospitals, age and ASA II proportion increased over time. Multivariable Cox regression demonstrated a lower revision risk for primary THA (HR 0.7, CI 0.7-0.8), TKA (HR 0.8, CI 0.7-0.9), and UKA (HR 0.8, CI 0.7-0.9) in private hospitals. After initial arthroplasty in private hospitals, 49% of THA and 37% of TKA revisions were performed in public hospitals.

CONCLUSION:

Patients in private hospitals were younger, had lower ASA classification, lower BMI, and higher SES com-pared with public hospital patients. The number of arthroplasties increased in private hospitals, with a lower revision risk compared with public hospitals.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Reoperação / Sistema de Registros / Hospitais Privados / Artroplastia de Quadril / Artroplastia do Joelho / Hospitais Públicos Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Reoperação / Sistema de Registros / Hospitais Privados / Artroplastia de Quadril / Artroplastia do Joelho / Hospitais Públicos Idioma: En Ano de publicação: 2024 Tipo de documento: Article