Over time, little comorbidity variation seen in patients with total hip, knee replacement
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In patients who undergo total hip replacement or total knee replacement, there has been little change in comorbidity profiles over time, according to presented results.
“In patients undergoing THR or TKR, there has been little change in comorbidity burden over the observed study time period. However, [there has been] some difference in the prevalence of specific comorbidities although most remained relatively constant,” Stephen E. Graves, MD, said at the Virtual EFORT Congress.
Graves and colleagues conducted a registry study using Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) data from 2003 to 2017 to quantify the preoperative morbidity profile of patients who had primary THA and TKA for osteoarthritis and to evaluate the trends in the comorbidities over time. The AOANJRR is linked to the Australian Pharmaceutical Benefits Scheme data.
Overall, 291,758 patients who had THR and 350,009 patients who had TKR were included in the study. They used medication dispensing histories for patients in the year prior to joint replacement surgery to determine the 47 comorbidity classes. Median comorbidity score for both groups of patients was 5.
For patients in the THR group, the most frequently observed comorbidities were pain, as measured by opioids use, hypertension, inflammation/pain, as measured by use of NSAIDs, and gastroesophageal reflux disease. Depression was a common comorbidity, particularly among younger patients in both groups. Pain, inflammation and hypertension were more prevalent in the older patients in both groups. Hypertension, hyperlipidemia and gastroesophageal reflux disease were more prevalent in older patients ,with increased prevalence seen among patients in the TKR group.
Graves said trends in median comorbidity scores were consistent across the 14-year period of data.
“Variations in comorbidity prevalence may, impart, reflect changes in clinical practice and medicine variability,” he said.
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Graves SE, et al. Paper 1801. Presented at: Virtual EFORT Congress; Oct. 28-30, 2020.
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