Background
Methods
Study design
Data source
Inclusion and exclusion criteria
Data extraction
Statistical analysis
Results
Type of Adverse Event | Number of Events (percent of total) | 90-Day Event Risk (%) | Mean Days from Surgery to Event |
---|---|---|---|
Prolonged paina
| 360 (31.36) | 23.19 | --- |
Persistent swelling | 86 (7.40) | 5.54 | 50.12 |
Draining of wounds | 56 (4.87) | 3.73 | 24.78 |
Non-healing of wound | 56 (4.87) | 3.61 | 30.38 |
Revision within 90 days of procedure | 50 (4.36) | 3.22 | 40.96 |
Acute blood loss anemia | 50 (4.36) | 3.22 | 1.92 |
Surgical site infection | 44 (3.83) | 2.84 | 27.09 |
Neuralgia | 32 (2.78) | 2.06 | 56.22 |
Death | 25 (2.18) | 1.61 | 30.44 |
DVT | 21 (1.83) | 1.35 | 21.95 |
Hospital stay longer than 30 days | 10 (0.87) | 0.64 | 41.70 |
Sepsis | 4 (0.35) | 0.26 | 24.00 |
Long term bleeding | 2 (0.17) | 0.13 | 13.00 |
Wrong site surgery | 0 | 0 | 0 |
Otherb
| 362 (31.53) | 23.32 | 17.47 |
Procedure Type | Number of Procedures | Percent of all Study Procedures | Total Number of Adverse Events | Percent of all Adverse Events | Mean Number of Events per Procedure |
---|---|---|---|---|---|
Total hip arthroplasty | 313 | 20.17 | 179 | 15.59 | 0.57 |
Total knee arthroplasty | 252 | 16.24 | 243 | 21.17 | 0.96 |
Lumbar arthrodesis posterior - single | 132 | 8.51 | 186 | 16.20 | 1.41 |
Removal of deep implant | 132 | 8.51 | 79 | 6.88 | 0.60 |
Open treatment of femur fracture & interlocking nail | 65 | 4.19 | 78 | 6.79 | 1.20 |
Arthroscopy of the knee and partial menisectomy | 64 | 4.12 | 18 | 1.57 | 0.28 |
Debridement: skin, tissue, muscle, bone | 60 | 3.87 | 71 | 6.18 | 1.18 |
Anterior cruciate ligament repair with arthroscopy and autograft | 53 | 3.41 | 11 | 0.96 | 0.21 |
Open treatment femoral fracture proximal end/neck with fixation | 53 | 3.41 | 43 | 3.75 | 0.81 |
Neurolysis median nerve at carpal T | 38 | 2.45 | 12 | 1.05 | 0.32 |
Application of external fixation system, unilateral; uniplanar | 31 | 2.00 | 46 | 4.01 | 1.48 |
Slipped capital femoral epiphysis with femoral neck osteoplasty | 31 | 2.00 | 14 | 1.22 | 0.45 |
Arthroscopy of shoulder, surgical; with rotator cuff repair | 32 | 2.06 | 12 | 1.05 | 0.38 |
Open treatment and fixation of the clavicle | 29 | 1.87 | 14 | 1.22 | 0.48 |
Gastronemius recession | 29 | 1.87 | 26 | 2.26 | 0.90 |
Excisional bone biopsy - deep | 25 | 1.61 | 12 | 1.05 | 0.48 |
Arthroscopy of the shoulder, surgical; capsulor repair | 24 | 1.55 | 6 | 0.52 | 0.25 |
Arthroscopy of the shoulder with acromioplasty | 22 | 1.42 | 8 | 0.70 | 0.36 |
Arthroscopy, debridge, drill, resect | 17 | 1.10 | 7 | 0.61 | 0.41 |
Removal of exterior fixator system | 16 | 1.04 | 12 | 1.05 | 0.75 |
Open toe flexor tenotomy, single | 15 | 0.97 | 8 | 0.70 | 0.53 |
Other study procedures | 130 | 8.38 | 82 | 0.07 | 0.78 |
Total study procedures | 1552 | 100 | 1148 | 100 | 0.73 |
Adverse Event | Total Hip Arthroplasty, N = 313 # (%) | Total Knee Arthroplasty, N = 252 # (%) | Total |
---|---|---|---|
Death | 1 (0.6) | 1 (0.4) | 2 |
Hospital stay longer than 30 days | 0 | 0 | 0 |
Revision within 90 days of procedure | 7 (3.9) | 21 (8.6%) | 28 |
Wrong site surgery | 0 | 0 | 0 |
Long term bleeding | 0 | 1 (0.4) | 1 |
Non-healing of wound | 4 (2.2) | 12 (4.9) | 16 |
Persistent swelling | 2 (1.1) | 31 (12.8) | 33 |
Surgical site infection | 7 (3.9) | 6 (2.5) | 13 |
Sepsis | 0 | 0 | 0 |
Draining of wounds | 13 (7.3) | 4 (1.6) | 17 |
DVT | 1 (0.6) | 1 (0.4) | 2 |
Prolonged Pain | 59 (33.0) | 78 (32.1) | 137 |
Nerve Pain | 4 (2.2) | 2 (0.8) | 6 |
Acute Blood Loss Anemia | 7 (3.9) | 8 (3.3) | 15 |
Other | 75 (41.9) | 77 (31.7) | 152 |
Totals | 179 | 243 | 422 |
Number of Adverse Events | Including Pain | Excluding Pain | ||
---|---|---|---|---|
Total Number of Patients | Percentage | Total Number of Patients | Percentage | |
0 | 828 | 53.01 | 1050 | 67.22 |
1 | 470 | 30.09 | 338 | 21.64 |
2 | 160 | 10.24 | 101 | 6.47 |
3 | 63 | 4.03 | 42 | 2.69 |
4 | 24 | 1.54 | 20 | 1.28 |
5 | 11 | 0.70 | 7 | 0.45 |
6 | 5 | 0.32 | 4 | 0.26 |
7 | 1 | 0.06 | 0 | 0 |
Predictors | Incidence Rate Ratio | 95% CI |
p-value |
---|---|---|---|
A. All Procedures (N = 1192) | |||
Crude Associations | |||
Age (decade) | 1.00 | 0.95–1.06 | 0.87 |
Sex (male coded as 1) | 0.99 | 0.81–1.21 | 0.91 |
CCI score (per 1 point) | 1.20 | 1.11–1.31 | <0.001 |
FCI score (per 1 point) | 1.34 | 1.23–1.45 | <0.001 |
Adjusted Models | |||
Model 1
| |||
Age (decade) | 1.00 | 0.95–1.06 | 0.92 |
Sex | 0.99 | 0.81–1.21 | 0.95 |
CCI score (per 1 point) | 1.20 | 1.11–1.31 | <0.001 |
Model 2
| |||
Age (decade) | 0.99 | 0.94–1.04 | 0.67 |
Sex | 0.99 | 0.81–1.22 | 0.97 |
FCI score (per 1 point) | 1.34 | 1.23–1.46 | <0.001 |
B. THA and TKA Procedures Only (N = 413) | |||
Crude Associations | |||
Age (decade) | 1.16 | 1.01–1.33 | 0.03 |
Sex | 1.15 | 0.82–1.62 | 0.41 |
CCI score (per 1 point) | 1.20 | 1.04–1.39 | 0.02 |
FCI score (per 1 point) | 1.24 | 1.09–1.41 | 0.001 |
Adjusted Models | |||
Model 1
| |||
Age (decade) | 1.15 | 1.00–1.32 | 0.04 |
Sex | 1.13 | 0.80–1.60 | 0.47 |
CCI score (per 1 point) | 1.18 | 1.02–1.37 | 0.03 |
Model 2
| |||
Age (decade) | 1.12 | 0.99–1.29 | 0.08 |
Sex | 1.16 | 0.82–1.64 | 0.40 |
FCI score (per 1 point) | 1.22 | 1.07–1.39 | <0.001 |
Predictors | Risk Ratio | 95% CI |
p-value |
---|---|---|---|
Panel A: All Procedures (N = 1192) | |||
Crude Associations | |||
Age (decade) | 1.03 | 0.99–1.07 | 0.12 |
Sex | 1.02 | 0.81–1.29 | 0.85 |
CCI score (per 1 point) | 1.10 | 1.02–1.18 | 0.01 |
FCI score (per 1 point) | 1.19 | 1.13–1.25 | <0.001 |
Adjusted Models | |||
Model 1
| |||
Age (decade) | 1.03 | 0.99–1.07 | 0.13 |
Sex | 1.04 | 0.82–1.30 | 0.76 |
CCI score (per 1 point) | 1.10 | 1.01–1.18 | 0.02 |
Model 2
| |||
Age (decade) | 1.02 | 0.98–1.06 | 0.28 |
Sex | 1.03 | 0.82–1.30 | 0.80 |
FCI score (per 1 point) | 1.19 | 1.13–1.25 | <0.001 |
Panel B: THA and TKA Procedures Only (N = 413) | |||
Crude Associations | |||
Age (decade) | 1.12 | 0.96–1.31 | 0.15 |
Sex | 1.23 | 1.01–1.50 | 0.04 |
CCI score (per 1 point) | 1.09 | 0.98–1.20 | 0.104 |
FCI score (per 1 point) | 1.14 | 1.07–1.22 | <0.001 |
Adjusted Models | |||
Model 1
| |||
Age (decade) | 1.12 | 0.97–1.28 | 0.12 |
Sex | 1.22 | 0.98–1.51 | 0.07 |
CCI score (per 1 point) | 1.07 | 0.99–1.15 | 0.07 |
Model 2
| |||
Age (decade) | 1.11 | 0.96–1.27 | 0.16 |
Sex | 1.23 | 1.01–1.51 | 0.04 |
FCI score (per 1 point) | 1.13 | 1.06–1.21 | <0.001 |
Predictors | Prevalence Ratio | 95% CI |
p-value |
---|---|---|---|
Panel A: All Procedures (N = 1552) | |||
Crude Associations | |||
Age (decade) | 1.02 | 0.97–1.08 | 0.36 |
Sex | 0.85 | 0.68–1.05 | 0.13 |
CCI score (per 1 point) | 1.02 | 0.88–1.19 | 0.77 |
FCI score (per 1 point) | 1.10 | 1.02–1.20 | 0.02 |
Adjusted Models | |||
Model 1
| |||
Age (decade) | 1.02 | 0.97–1.08 | 0.38 |
Sex | 0.85 | 0.68–1.05 | 0.14 |
CCI score (per 1 point) | 1.02 | 0.87–1.20 | 0.81 |
Model 2
| |||
Age (decade) | 1.02 | 0.97–1.07 | 0.46 |
Sex | 0.85 | 0.68–1.06 | 0.16 |
FCI score (per 1 point) | 1.10 | 1.01–1.19 | 0.03 |
Panel B THA and TKA Procedures Only (N = 550) | |||
Crude Associations | |||
Age (decade) | 0.98 | 0.92–1.05 | 0.57 |
Sex | 1.42 | 1.10–1.85 | 0.01 |
CCI score (per 1 point) | 1.03 | 0.86–1.24 | 0.76 |
FCI score (per 1 point) | 1.06 | 1.01–1.12 | 0.03 |
Adjusted Models | |||
Model 1
| |||
Age (decade) | 0.98 | 0.91–1.06 | 0.68 |
Sex | 1.42 | 1.09–1.86 | 0.01 |
CCI score (per 1 point) | 1.02 | 0.84–1.25 | 0.82 |
Model 2
| |||
Age (decade) | 0.98 | 0.91–1.05 | 0.56 |
Sex | 1.42 | 1.10–1.85 | 0.01 |
FCI score (per 1 point) | 1.06 | 1.01–1.13 | 0.03 |