The American Joint Replacement Registry-the first 5 years.
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ABSTRACT:
SUBMITTER: Etkin CD
PROVIDER: S-EPMC5485224 | biostudies-literature | 2017 Jun
REPOSITORIES: biostudies-literature
Publications
The American Joint Replacement Registry-the first 5 years.
Etkin Caryn D CD Springer Bryan D BD
Arthroplasty today 20170314 2
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Project description:In October 2015, the Centers for Medicare & Medicaid Services transitioned from the 9th version of the International Classification of Diseases (ICD-9) codes for reporting patient diagnosis and medical procedures to the 10th version (ICD-10). The multitude of coding options for total joint arthroplasty in ICD-10-procedural coding (ICD-10-PCS) poses some challenges for the American Joint Replacement Registry (AJRR) in identifying precise procedures being reported. While AJRR participating hospitals are familiar with ICD-10-PCS, this new coding may not have been introduced to most AJRR participating surgeons. To address these issues, AJRR initiated an ICD-10 workgroup to define and map appropriate ICD-10 codes to total joint procedure types. This initiative sought to improve accuracy of AJRR data.
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Project description:The 2019 American Joint Replacement Registry shows continued growth in cases and data recorded. There are several trends noted in the registry that have been highlighted in this brief communication. More granular data collection is projected for future reports that may shed light on specific procedure and device survivorship and patient-reported outcomes. The authors encourage you to read the full report, available at the following link: http://ajrr.net/publications-data/annual-reports.
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Project description:The 2022 American Joint Replacement Registry Annual Report includes data from over 2.8 million hip and knee procedures from over 1,250 institutions that encompass all 50 states and the District of Columbia. This represents a cumulative registered procedural volume growth of 14% compared to the previous year, making the American Joint Replacement Registry the largest arthroplasty registry by volume in the world.
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Project description:BackgroundDespite previous studies showing benefits of spinal anesthesia (SA) for patients undergoing elective total hip arthroplasty (THA), most THA procedures throughout the United States still utilize general anesthesia (GA). Using the American Joint Replacement Registry data, our study explored outcome difference for patients undergoing THA administered SA vs GA.MethodsAll available THAs were identified using American Joint Replacement Registry data from 2017 to 2020. THA patients were categorized into 2 cohorts by anesthesia type. Demographics, hospital characteristics, and comorbidities were documented for each patient. Outcomes included operative time, length of stay, 30- and 90-day readmission, and 90-day all-cause revision. Chi-square analysis was used to assess categorical variables while multivariable regression analyzed the association between anesthesia type and outcomes of interest.ResultsA total of 217,124 THAs were identified, including 119,425 (55.0%) patients who received GA and 97,699 (45.0%) patients who received SA. Multivariable regression showed that SA was associated with a decreased risk of hospital length of stay >3 days (adjusted odds ratio [aOR] 0.4, 95% confidence interval [CI]: 0.34-0.36, P < .0001) and a lower likelihood of prolonged operative time (aOR 0.8, 95% CI: 0.79-0.82, P < .0001). Additionally, patients who received SA had lower rates of 90-day readmission (aOR 0.7, 95% CI: 0.67-0.78, P < .0001) and a decreased risk of 90-day all-cause revision (aOR 0.5, 95% CI: 0.47-0.54, P < .0001).ConclusionsPatients receiving SA during THA had shorter operative time, reduced length of stay, and decreased rates of readmission and revision compared to patients who received GA. These findings add to the growing body of literature supporting the benefits of SA over GA for THA patients.
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Project description:BackgroundRevision total knee arthroplasty (TKA) is associated with a higher complication rate and a greater cost when compared to primary TKA. Based on patient choice, referral, or patient transfers, revision TKAs are often performed in different institutions by different surgeons than the primary TKA. The aim of this study is to evaluate the effect of hospital size, teaching status, and revision indication on the migration patterns of failed primary TKA in patients 65 years of age and older.MethodsAll primary and revision TKAs reported to the American Joint Replacement Registry from January 2012 through March 2020 were included and merged with the Centers for Medicare and Medicaid Services database. Migration was defined as a patient having a primary TKA and revision TKA performed at separate institutions by different surgeons.ResultsIn total, 9167 linked primary and revision TKAs were included in the analysis. Overall migration rates were significantly higher from small (<100 beds; P = .019), non-teaching institutions (P = .002) driven primarily by patients diagnosed with infection. Infection patients had significantly higher migration rates from small (46.8%, P < .001), non-teaching (43.5%, P < .001) institutions, while migration rates for other causes of revision were statistically similar. Most patients migrated to medium or large institutions (84.7%) for revision TKA rather than small institutions (15.3%, P < .001) and to teaching (78.3%) rather than non-teaching institutions (21.7%, P < .001).ConclusionThere is a diagnosis-dependent referral bias that affects the migration rates of infected primary TKA from small non-teaching institutions leading to a flow of more medically complex patients to medium and large teaching institutions for infected revision TKA.
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Project description:The Canadian Joint Replacement Registry (CJRR) was launched in 2000 through the collaborative efforts of the Canadian Orthopedic Association and the Canadian Institutes for Health Information. Participation is voluntary, and data collected by participating surgeons in the operating room is linked to hospital stay information from administrative databases to compile yearly reports. In the fiscal year 2006-2007, there were 62,196 hospitalizations for hip and knee replacements in Canada, excluding Quebec. This represents a 10-year increase of 101% and a 1-year increase of 6%. Compared to men, Canadian women have higher age-adjusted rates per 105 for both TKA (148 vs. 110) and THA (86 vs. 76). There also exist substantial inter-provincial variations in both age-adjusted rates of arthroplasty and implant utilization that cannot be explained entirely on the basis of differing patient demographics. The reasons for these variations are unclear, but probably represent such factors as differences in provincial health expenditure, efforts to reduce waiting lists, and surgeon preference. The main challenge currently facing the CJRR is to increase procedure capture to > 90%. This is being pursued through a combination of efforts including simplification of the consent process, streamlining of the data collection form, and the production of customized reports with information that has direct clinical relevance for surgeons and administrators. As the CJRR continues to mature, we are optimistic that it will provide clinically important information on the wide range of factors that affect arthroplasty outcome.
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