Horn Andrew R, Diamond Keith B, Ng Mitchell K, Vakharia Rushabh M, Mont Michael A, Erez Orry
Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA.
Department of Orthopaedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY, USA.
Hip Pelvis. 2021 Dec;33(4):231-238. doi: 10.5371/hp.2021.33.4.231. Epub 2021 Dec 1.
Alcohol use disorder is a leading mental health disorder in the United States. Few studies evaluating the association of alcohol use disorder following primary total hip arthroplasty (THA) have been reported. Therefore, the purpose of this study was to determine whether patients with alcohol use disorder undergoing primary THA have higher rates of: 1) in-hospital lengths of stay (LOS); 2) complications (medical/implant-related); and 3) costs.
Using a nationwide claims database from January 1st, 2005 to March 31st, 2014, patients with alcohol use disorder undergoing primary THA were identified and matched to a comparison group according to age, sex, and various comorbidities, resulting in 230,467 patients who were included in the study (n=38,416) and a matched-cohort (n=192,051). Outcomes of interest included comparison of LOS, 90-day medical and 2-year implant-related complications, and costs. A -value less than 0.002 was considered statistically significant.
Patients with alcohol use disorder had longer in-hospital LOS (4 days vs 3 days; <0.0001) as well as higher frequency and odds ratio (OR) of 90-day medical (45.94% vs 12.25%; OR, 2.89; <0.0001) and 2-year implant-related complications (17.71% vs 8.46%; OR, 1.97; <0.0001). Patients in the study group incurred higher 90-day costs of care ($17,492.63 vs $14,921.88; <0.0001).
With the growing prevalence of alcohol use disorder in the United States, the current investigation can be utilized to evaluate the need for interventions prior to THA which can potentially minimize the rates of morbidity and mortality within this population.
酒精使用障碍是美国主要的心理健康障碍。很少有研究评估初次全髋关节置换术（THA）后酒精使用障碍之间的关联。因此，本研究的目的是确定接受初次THA的酒精使用障碍患者是否在以下方面具有更高的发生率：1）住院时间（LOS）；2）并发症（医疗/植入物相关）；3）费用。
利用2005年1月1日至2014年3月31日的全国索赔数据库，识别出接受初次THA的酒精使用障碍患者，并根据年龄、性别和各种合并症与一个对照组进行匹配，最终有230,467名患者纳入研究（n = 38,416）和一个匹配队列（n = 192,051）。感兴趣的结果包括住院时间、90天医疗和2年植入物相关并发症以及费用的比较。P值小于0.002被认为具有统计学意义。
酒精使用障碍患者的住院时间更长（4天对3天；P < 0.0001），90天医疗并发症的发生率和比值比（OR）更高（45.94%对12.25%；OR，2.89；P < 0.0001），2年植入物相关并发症的发生率和比值比也更高（17.71%对8.46%；OR，1.97；P < 0.0001）。研究组患者的90天护理费用更高（17,492.63美元对14,921.88美元；P < 0.0001）。
随着美国酒精使用障碍患病率的不断上升，当前的研究可用于评估THA术前干预的必要性，这可能会降低该人群的发病率和死亡率。
