Journal of Pharmaceutical Care & Health Systems
Open Access
ISSN: 2376-0419
+44 1300 500008
ISSN: 2376-0419
+44 1300 500008
Jasvinder Singh
University of Alabama, USA
Posters-Accepted Abstracts: J Pharma Care Health Sys
Our study objective was to examine whether Avascular Necrosis (AVN) as an underlying diagnosis was associated with a higher adjusted risk of complications and readmissions after primary Total Hip Arthroplasty (THA), compared to Osteoarthritis (OA). We analyzed prospectively collected data from a Total Joint Replacement Registry of adults with AVN vs. OA undergoing unilateral primary THA during 2001-2012. We examined mortality (90-day), revision (ever), deep (1 year) and superficial (30-day) Surgical Site Infection (SSI), venous thromboembolism (VTE, 90-day), and unplanned readmission (90-day). Age, gender, race, body mass index, American Society of Anesthesiologists class, and diabetes prevalence were evaluated as confounders. Logistic and Cox regression models were fit with variables significant in univariate models for each outcome. Odds Ratios (OR) and hazard ratios with 95% Confidence Intervals (CI) were calculated. Of the 47,523 primary THA cases, 45,252 (95.2%) had OA, and 2,271 (4.8%) had AVN. Compared to the OA cohort, the AVN patient cohort was younger (55 vs. 67 years), more male (57.5% vs. 41.7%), and less White (59.8% vs. 77.4%). Compared to the OA cohort, the AVN cohort had higher crude incidence of 90-day mortality (0.7% vs. 0.3%), revision (3.1% vs. 2.4%), SSI (1.2% vs. 0.8%), and unplanned readmission (9.6% vs. 5.2%). After multivariable-adjustment for significant factors, AVN patients had a higher likelihood of mortality (OR:2.48; 95% CI:1.31-4.72), SSI (OR:1.67, 95%CI:1.11-2.51), and unplanned readmissions (OR:2.20; 95% CI:1.67-2.91) than OA patients. Detailed discussion with AVN patients regarding the risk of complications is needed during the informed consent.
Email: jasvinder.md@gmail.com