全腕关节置换术应用的趋势与人口统计学特征
Trends and Demographics in the Utilization of Total Wrist Arthroplasty.
作者信息
Elbuluk Ameer M, Milone Michael T, Capo John T, Bosco Joseph A, Klifto Christopher S
机构信息
† Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
* Department of Orthopaedic Surgery, NYU Langone Medical Center, Hospital for Joint Diseases, New York, NY, USA.
出版信息
J Hand Surg Asian Pac Vol. 2018 Dec;23(4):501-505. doi: 10.1142/S2424835518500492.
BACKGROUND
Health disparities exist among many patient populations, with race, payer status, hospital size and access to teaching versus non-teaching hospitals potentially affecting whether certain patients have access to the benefits of total wrist arthroplasty (TWA).
METHODS
The National Inpatient Sample Database (NIS) was queried from 2001 to 2013 for TWA using the ICD-9 code 81.73. Patient-level data included age, sex, race, payer status, and year of discharge. Hospital-level data included hospital bed size, location, teaching status, and region.
RESULTS
There were 1,213 patients identified who underwent TWA between 2001 and 2013. Total number of procedures decreased from 88 TWAs in 2001 to 65 in 2013. The yearly volume ranged from 33 in 2005 to 128 in 2007. The male-female ratio was 2.5 to 1. The majority of TWA procedures were performed at urban teaching hospitals (60.8%).
CONCLUSIONS
The NIS database shows a downward trend of total wrist arthroplasty utilization. The majority of total wrist arthroplasties were performed at urban teaching hospitals indicating treatment occurs most often at academic centers of excellence.
背景
许多患者群体中存在健康差异，种族、支付者身份、医院规模以及能否进入教学医院与非教学医院，可能会影响某些患者是否能够获得全腕关节置换术（TWA）的益处。
方法
利用国际疾病分类第九版（ICD-9）编码81.73，在2001年至2013年期间查询国家住院患者样本数据库（NIS）中的全腕关节置换术情况。患者层面的数据包括年龄、性别、种族、支付者身份以及出院年份。医院层面的数据包括医院床位规模、位置、教学状况和地区。
结果
2001年至2013年期间，共识别出1213例行全腕关节置换术的患者。手术总数从2001年的88例降至2013年的65例。年手术量在2005年为33例，2007年为128例。男女比例为2.5比1。大多数全腕关节置换术在城市教学医院进行（60.8%）。
结论
NIS数据库显示全腕关节置换术的利用率呈下降趋势。大多数全腕关节置换术在城市教学医院进行，这表明治疗大多发生在卓越的学术中心。
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