PDF(Pubmed)
Abstract：
UNASSIGNED: Revision hip and knee total joint arthroplasty (TJA) carries a high burden of postoperative complications, including surgical site infections (SSI), venous thromboembolism (VTE), reoperation, and readmission, which negatively affect postoperative outcomes and patient satisfaction. Socioeconomic area-level composite indices such as the area deprivation index (ADI) are increasingly important measures of social determinants of health (SDoH). This study aims to determine the potential association between ADI and SSI, VTE, reoperation, and readmission occurrence 90 days following revision TJA.
UNASSIGNED: 1047 consecutive revision TJA patients were retrospectively reviewed. Complications, including SSI, VTE, reoperation, and readmission, were combined into one dependent variable. ADI rankings were extracted using residential zip codes and categorized into quartiles. Univariate and multivariate logistic regressions were performed to analyze the association of ADI as an independent factor for complication following revision TJA.
UNASSIGNED: Depression (p = 0.034) and high ASA score (p < 0.001) were associated with higher odds of a combined complication postoperatively on univariate logistic regression. ADI was not associated with the occurrence of any of the complications recorded following surgery (p = 0.092). ASA remained an independent risk factor for developing postoperative complications on multivariate analysis.
UNASSIGNED: An ASA score of 3 or higher was significantly associated with higher odds of developing postoperative complications. Our findings suggest that ADI alone may not be a sufficient tool for predicting postoperative outcomes following revision TJA, and other area-level indices should be further investigated as potential markers of social determinants of health.
UNASSIGNED: 1047 consecutive revision TJA patients were retrospectively reviewed. Complications, including SSI, VTE, reoperation, and readmission, were combined into one dependent variable. ADI rankings were extracted using residential zip codes and categorized into quartiles. Univariate and multivariate logistic regressions were performed to analyze the association of ADI as an independent factor for complication following revision TJA.
UNASSIGNED: Depression (p = 0.034) and high ASA score (p < 0.001) were associated with higher odds of a combined complication postoperatively on univariate logistic regression. ADI was not associated with the occurrence of any of the complications recorded following surgery (p = 0.092). ASA remained an independent risk factor for developing postoperative complications on multivariate analysis.
UNASSIGNED: An ASA score of 3 or higher was significantly associated with higher odds of developing postoperative complications. Our findings suggest that ADI alone may not be a sufficient tool for predicting postoperative outcomes following revision TJA, and other area-level indices should be further investigated as potential markers of social determinants of health.
摘要：
■髋关节和膝关节全关节置换术（TJA）的术后并发症负担很高，包括手术部位感染（SSI），静脉血栓栓塞症(VTE),再操作,和重新接纳，对术后结果和患者满意度产生负面影响。诸如区域剥夺指数（ADI）之类的社会经济区域级综合指数是衡量健康的社会决定因素（SDoH）的越来越重要的指标。本研究旨在确定ADI和SSI之间的潜在关联，VTE,再操作,以及修订TJA后90天的再入院发生。
■1047例连续修订的TJA患者进行回顾性分析。并发症,包括SSI,VTE,再操作,和重新接纳，被组合成一个因变量。ADI排名是使用住宅邮政编码提取的，并分为四分位数。采用单因素和多因素Logistic回归分析ADI作为修正TJA后并发症的独立因素。
■抑郁(p=0.034)和高ASA评分(p<0.001)与术后合并并发症的概率较高相关。ADI与手术后记录的任何并发症的发生无关（p=0.092）。根据多变量分析，ASA仍然是发生术后并发症的独立危险因素。
■ASA评分为3分或更高与发生术后并发症的几率显著相关。我们的研究结果表明，仅ADI可能不足以预测TJA修订后的术后结果。和其他地区一级的指数应进一步调查，作为健康的社会决定因素的潜在标志。
■1047例连续修订的TJA患者进行回顾性分析。并发症,包括SSI,VTE,再操作,和重新接纳，被组合成一个因变量。ADI排名是使用住宅邮政编码提取的，并分为四分位数。采用单因素和多因素Logistic回归分析ADI作为修正TJA后并发症的独立因素。
■抑郁(p=0.034)和高ASA评分(p<0.001)与术后合并并发症的概率较高相关。ADI与手术后记录的任何并发症的发生无关（p=0.092）。根据多变量分析，ASA仍然是发生术后并发症的独立危险因素。
■ASA评分为3分或更高与发生术后并发症的几率显著相关。我们的研究结果表明，仅ADI可能不足以预测TJA修订后的术后结果。和其他地区一级的指数应进一步调查，作为健康的社会决定因素的潜在标志。
