Revision Total Hip Arthroplasty in Solid Organ Transplant Patients: A Propensity Score-Matched Cohort Study for Aseptic and Infected Revisions

Abstract

Background Previous studies have demonstrated that solid organ transplant (SOT) patients undergoing primary total hip arthroplasty (THA) are at an increased risk of postoperative complications. The purpose of this study is to use a large, national database to investigate revision THA (rTHA) outcomes in SOT patients. Methods Nationwide Readmissions Database (NRD) from 2010-2018 was used, and ICD-9 and ICD-10 codes were used to identify all patients who underwent rTHA, including those with history of SOT. Propensity score matching (PSM) was used to analyze rTHA outcomes in SOT patients comparted to matched controls. Separate analysis performed for patients undergoing rTHA for prosthetic joint infection (PJI) vs other causes. Results A total of 414,756 rTHA, with 1837 of those being performed in SOT patients, were identified. Of these, 65,961 and 276 were performed for PJI in non-SOT and SOT patients, respectively. For non-PJI patients, SOT patients had higher 90-day all-cause readmission rates (24.0% vs 19.4%, P = .03) but lower rate for readmission related to rTHA (6.0% vs 9.2%, P = .03), but no difference readmission for specific rTHA complications, mortality (0.6% vs 1.3%, P = .20), or revision rTHA. Of PJI patients, SOT patients had no difference in overall 90-day readmission (38.6 vs 31.3%, P = .280), readmission for specific rTHA complications, re-revision, or mortality (4.7% vs 6.0%, P = .63). Conclusions SOT patients undergoing rTHA for aseptic reasons are higher risk of overall readmission but lower risk of readmission related to rTHA than appropriately matched controls. SOT PJI patients undergoing had similar rates of readmission, mortality, and revision surgery compared to matched non-SOT PJI patients.

National trends in the utilization of lumbar disc replacement for lumbar degenerative disc disease over a 10-year period, 2010 to 2019

“…Costs were inflation-adjusted based on admission month using rates from United States (US) Bureau of Labor Statistics and described in December 2019 U.S. dollars ( 15 ). Index hospitalization complications were defined using ICD-9 and ICD-10 codes reported in ( 16 ) with the addition of neurologic complication codes (ICD-9 997 and 349.31; ICD-10 G97 and G96). The following complication categories were analyzed: cardiac complications, neurologic complications, myocardial infarction, cerebrovascular accident (CVA), respiratory complications, pneumonia (PNA), pulmonary embolism (PE), other pulmonary complications, deep vein thrombosis (DVT), acute kidney injury, wound complications, post-operative blood transfusions or any in-hospital complications.…”

129. National trends in the utilization of lumbar disc replacement for lumbar degenerative disc disease over a 10-year period, 2010 to 2019

“…Costs were inflationadjusted based on admission month using rates from United States (US) Bureau of Labor Statistics and described in December 2019 U.S. dollars (15). Index hospitalization complications were defined using ICD-9 and ICD-10 codes reported in (16) with the addition of neurologic complication codes (ICD-9 997 and 349.31; ICD-10 G97 and G96). The following complication categories were analyzed: cardiac complications, neurologic complications, myocardial infarction, cerebrovascular accident (CVA), respiratory complications, pneumonia (PNA), pulmonary embolism (PE), other pulmonary complications, deep vein thrombosis (DVT), acute kidney injury, wound complications, post-operative blood transfusions or any inhospital complications.…”