Racial and Ethnic Disparities in Short-Stay Total Knee Arthroplasty

医学 民族 体质指数 回顾性队列研究 心理干预 回廊的 队列 物理疗法 内科学 人类学 精神科 社会学
作者
Aoife MacMahon,Kevin L. Mekkawy,Kawsu Barry,Harpal S. Khanuja
出处
期刊:Journal of Arthroplasty [Elsevier BV]
卷期号:38 (7): 1217-1223 被引量:7
标识
DOI:10.1016/j.arth.2022.12.044
摘要

Abstract

Background

The purpose of this study was to understand racial and ethnic disparities in hospital-based, Medicare-defined outpatient total knee arthroplasty (TKA). We aimed to determine the following: 1) whether there are differences in preoperative characteristics or postoperative outcomes in outpatient TKA between racial/ethnic groups and 2) trends in outpatient TKA volume, based on race/ethnicity.

Methods

This was a retrospective cohort study of a large national database. Outpatient TKAs performed between 2012 and 2018 were identified. Patient demographics, comorbidities, and 30-day postoperative outcomes were compared between White, Black, Asian, and Hispanic patients.

Results

Of 54,183 outpatient patients, 85.6% were White, 7.4% Black, 2.6% Asian, and 4.1% Hispanic. Black patients had the highest body mass index, and there were higher rates of diabetes among all minority groups (P < .001). All minority groups were more likely to be discharged to a rehabilitation or a skilled care facility compared to White patients (P < .001). Annual percentage increases in outpatient TKA were most pronounced for Asians and Hispanics and least pronounced among Blacks, when compared to White patients.

Conclusion

The outcomes of outpatient TKA are impacted by risk factors that reflect underlying disparities in healthcare. As joint arthroplasties have come off the inpatient-only list and procedures move to ambulatory settings, these disparities will likely magnify and impact outcomes, costs, and access points. Extensive preoperative optimization and interventions that target medical and social factors may help to reduce these disparities in TKA and increase access among minority patients.

Level of Evidence

III, retrospective cohort study.
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