Outcomes Following Primary Total Hip or Knee Arthroplasty in Substance Misusers
Section snippets
Data Source
The National Hospital Discharge Survey (NHDS) [13], developed by the National Center for Healthcare Statistics Division of the Centers for Disease Control and Prevention (CDC), was used in this study. The NHDS is considered the most comprehensive of all inpatient surgical databases in use today and is the principal database used by the U.S. government for monitoring hospital use [14]. Publicly available, the NHDS provides demographic and medical data for inpatients discharged from non-federal,
Results
A cohort representative of 8,379,490 patients who underwent primary THA or TKA between 1990 and 2007 was identified (Table 1). Of the total cohort, 13,163 patients had a diagnosis of drug misuse, while 8,366,327 patients had no diagnosis of drug misuse. The drug misuse group was younger (51.6 ± 12.9 years compared to 67.3 ± 11.7 years; P < 0.001), had longer hospital stays (5.3 ± 4.0 days compared to 5.1 ± 4.2 days; P < 0.001), and had a higher rate of patients who left against medical advice (0.4% compared to
Discussion
This study describes the influence of drug misuse on perioperative outcomes following primary THA or TKA. Although individuals who misuse drugs are thought to be at increased risk of inflammatory arthropathies, the indication for surgery in this population is complicated by a higher risk of infection 7., 8.. The results of this study show that patients who misuse drugs face prolonged hospital lengths of stay and higher odds of leaving against medical advice, mortality and complications
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Cited by (0)
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to http://dx.doi.org/10.1016/j.arth.2015.01.052.
- 1
Medical student, University of Miami Miller School of Medicine, Miami, FL, USA.
- 2
University of Miami Department of Orthopaedic Surgery and Rehabilitation, Miami, FL, USA.
- 3
Vice chair, Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA.