全关节置换术患者的住院资源利用及并发症趋势：一项回顾性队列研究
Trends in Inpatient Resource Utilization and Complications Among Total Joint Arthroplasty Recipients: A Retrospective Cohort Study.
作者信息
Yang Elaine I, Hong Genewoo, Gonzalez Della Valle Alejandro, Kim David H, Ranawat Amar S, Memtsoudis Stavros, Liu Jiabin
机构信息
Anesthesiology, Critical Care, and Pain Management (Dr. Yang, Dr. Hong, Dr. Kim, Dr. Memtsoudis, and Dr. Liu), Hospital for Special Surgery, Weill Cornell Medical Center and the Department of Orthopedic Surgery (Dr. Gonzalez Della Valle, and Dr. Ranawat), Hospital for Special Surgery, Weill Cornell Medical Center, New York, NY.
出版信息
J Am Acad Orthop Surg Glob Res Rev. 2018 Oct 16;2(10):e058. doi: 10.5435/JAAOSGlobal-D-18-00058. eCollection 2018 Oct.
INTRODUCTION
Joint arthroplasty practice is highly dynamic to adapt to economic changes and advances in medicine. This study provides updates of the current perioperative practice on healthcare resource utilization.
METHODS
The study included total knee arthroplasty, total hip arthroplasty, and total shoulder arthroplasty within the healthcare cost and utilization project New York State database from 2007 to 2013 (ie, 202,100, 127,872, and 8858 cases, respectively).
RESULTS
A higher proportion of sicker patients were prevalent over time. The length of stay decreased continuously. However, total hospital charges increased after adjusting for inflation. The incidence of wound infection and transfusion decreased steadily over time, whereas acute renal failure has been on the rise. There was an increased utilization of echocardiography, while decreased among other resources.
DISCUSSION
Total knee arthroplasty, total hip arthroplasty, and total shoulder arthroplasty changed toward sicker patients with shorter length of stay, fewer complications, and less resource utilization. However, overall costs increased over time.
引言
关节置换手术实践具有高度动态性，以适应经济变化和医学进步。本研究提供了当前围手术期医疗资源利用实践的最新情况。
方法
该研究纳入了2007年至2013年医疗成本与利用项目纽约州数据库中的全膝关节置换术、全髋关节置换术和全肩关节置换术（分别为202,100例、127,872例和8858例）。
结果
随着时间推移，病情较重的患者比例更高。住院时间持续缩短。然而，经通胀调整后，医院总费用有所增加。伤口感染和输血的发生率随时间稳步下降，而急性肾衰竭呈上升趋势。超声心动图的使用增加，而其他资源的使用减少。
讨论
全膝关节置换术、全髋关节置换术和全肩关节置换术的患者病情逐渐加重，住院时间缩短，并发症减少，资源利用降低。然而，总体成本随时间增加。
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