Association of Race/Ethnicity With Hospital Discharge Disposition After Elective Total Knee Arthroplasty

Singh, Jasvinder A; Kallan, Michael J.; Chen, Yong; Parks, Michael L.; Ibrahim, Said A.

doi:10.1001/jamanetworkopen.2019.14259

Cited by 46 publications

(45 citation statements)

References 53 publications

(90 reference statements)

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“…38 African-Americans and other non-Caucasians have lower rates of undergoing primary THA and TKA than their Caucasian counterparts and have historically been shown to have poorer outcomes. 14,33 Our findings demonstrate that non-Caucasian patients achieved lower overall postoperative PROM scores when compared to Caucasian patients following TJA. However, the improvement in scores from baseline preoperative levels was equivocal across racial groups and the clinical difference in scores was negligible.…”

Section: Discussionmentioning

confidence: 60%

“…This contrasts previous reports which demonstrate an increased risk of readmission and ED visits for African-American patients within 90 days following surgery. 7,14 BMI significantly differed between racial groups in both THA and TKA cohorts with African-Americans having the highest BMI between all racial groups. Increased BMI has been shown to directly impact total operating room times.…”

Section: Discussionmentioning

confidence: 96%

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Does racial background influence outcomes following total joint arthroplasty?

Singh

Realyvasquez

Kugelman

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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Background: The purpose of this study is to assess whether racial differences influence patient-reported outcome measures (PROMs) following primary total hip (THA) and knee (TKA) arthroplasty. Methods: We retrospectively reviewed patients who underwent primary THA or TKA from 2016 to 2020 with available PROMs. Both THA and TKA patients were separated into three groups based on their ethnicity: Caucasian, African-American, and other races. Patient demographics, clinical data, and PROMs at various time-periods were collected and compared. Demographic differences were assessed using chisquare and ANOVA. Univariate ANCOVA was utilized to compare outcomes and PROMs while accounting for demographic differences. Results: This study included 1999 THA patients and 1375 TKA patients. In the THA cohort, 1636 (82%) were Caucasian, 177 (9%) were African-American, and 186 (9%) were of other races. In the TKA cohort, 864 (63%) were Caucasian, 236 (17%) were African-American, and 275 (20%) were of other races. Surgicaltime significantly differed between the groups that underwent THA (88.4vs.100.5vs.96.1; p < 0.001) with African-Americans requiring the longest operative time. Length-of-stay significantly differed in both THA (1.5vs.1.9vs.1.8; p < 0.001) and TKA (2.1vs.2.5vs.2.3; p < 0.001) cohorts, with African-Americans having the longest stay. Caucasians reported significantly higher PROM scores compared to non-Caucasians in both cohorts. All-cause emergency-department (ED) visits, 90-day postoperative events (read-missions&revisions), and discharge-disposition did not statistically differ in both cohorts. Conclusion: Non-Caucasian patients demonstrated lower PROM scores when compared to Caucasian patients following TJA although the differences may not be clinically relevant. LOS was significantly longer for African-Americans in both THA and TKA cohorts. Further investigation identifying racial disparity interventions is warranted.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 96%

Does racial background influence outcomes following total joint arthroplasty?

Singh

Realyvasquez

Kugelman

et al. 2021

Journal of Clinical Orthopaedics and Trauma

View full text Add to dashboard Cite

show abstract

“…First, use of institutional postacute care has generally been associated with increased hospital readmissions. 11 Second, discharges to institutional postacute care, instead of home, are not always shaped by patients’ care needs. In a sample of patients who were potentially dischargeable to home vs an institutional postacute care facility, 38% were discharged to institutional postacute care facilities in the absence of any medical reason.…”

Section: Discussionmentioning

confidence: 99%

“…For example, postsurgery complication is more common for Black patients, contributing to increased readmission and mortality. 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 Black patients are more likely to receive institutional postacute care after joint replacement 11 , 12 , 13 and experience less functional improvement in postacute care settings after joint replacement. 14 Evidence about Hispanic-White differences in joint replacement care is mixed, with some studies reporting similar or lower risk of complications for Hispanic patients than for White patients, while others report higher risk of infections and other complications.…”

Section: Introductionmentioning

confidence: 99%