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Risk-adjustment models may accurately predict outcomes with TJA registry data
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Risk-adjustment models can be used to adequately compare surgeons, hospitals and devices using registry data for total joint arthroplasty procedures, according to study results.
Researchers analyzed the 90-day complication rates of 9,960 patients who underwent either total hip or knee arthroplasty at 22 medical centers enrolled in the California Joint Replacement Registry. Investigators used multivariable logistic risk models to compare rates of postoperative complications. They also used a risk-adjustment model to determine patient predictors for postoperative complications and calculated risk-adjusted complication rates from the hospitals.
Findings showed the mean unadjusted complication rate was 7.1%. According to results of the multivariable logistic risk model, the strongest predictors for complication rates were the American Society of Anesthesiologists class and age, followed by congestive heart failure and peripheral artery disease.
Investigators noted three hospitals had significantly worse complication rates than expected; however, one hospital had better complication rates than expected after risk adjustment. ‒ by Monica Jaramillo
Disclosures: SooHoo reports he is an Orthopedics Today Editorial Board member, and is also a board or committee member of the American Academy of Orthopaedic Surgeons and the American Orthopaedic Foot and Ankle Society. Please see the full study for a list of all other authors’ relevant financial disclosures.
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