Time trends and risk factors for perioperative complications in total ankle arthroplasty: retrospective analysis using a national database in Japan
Identifieur interne : 000982 ( Main/Exploration ); précédent : 000981; suivant : 000983Time trends and risk factors for perioperative complications in total ankle arthroplasty: retrospective analysis using a national database in Japan
Auteurs : Takumi Matsumoto [Japon] ; Hideo Yasunaga [Japon] ; Hiroki Matsui [Japon] ; Kiyohide Fushimi [Japon] ; Naohiro Izawa [Japon] ; Tetsuro Yasui [Japon] ; Yuho Kadono [Japon] ; Sakae Tanaka [Japon]Source :
- BMC Musculoskeletal Disorders [ 1471-2474 ] ; 2016.
Abstract
Total ankle arthroplasty (TAA) has become increasingly popular worldwide as an alternative to ankle arthrodesis for surgical treatment of end-stage ankle arthritis. The aim of this epidemiological study, using a national inpatient database in Japan, was to describe the volume, utilization, patient characteristics, and temporal trends regarding these procedures in Japan, and to identify the risk factors associated with perioperative adverse events in TAA.
This was a population-based, retrospective cohort study. We retrospectively identified 2775 patients in the Diagnosis Procedure Combination database who underwent ankle arthrodesis or TAA for ankle arthritis at 559 hospitals in Japan from 2007 to 2013. Information on sex, age, main diagnosis, use of blood transfusion, duration of anesthesia, length of hospital stay, in-hospital mortality, hospitalization costs, additional procedures after primary surgery, and use of negative pressure wound therapy was extracted. Multivariable logistic regression analysis was performed to analyze the effect of various factors on the incidence of perioperative adverse events in TAA, including additional procedure during hospitalization, negative pressure wound therapy, blood transfusion, and in-hospital death.
We identified 465 patients who underwent TAA and 2310 patients who underwent ankle arthrodesis. There was no apparent increase in the proportion of TAAs performed during the survey period. Patients undergoing TAA tended to be older, female, and have rheumatoid arthritis compared with those undergoing ankle arthrodesis. Patients undergoing TAA had shorter length of stay, higher hospitalization costs, and more blood transfusions compared with those undergoing ankle arthrodesis. Lower hospital volume and shorter anesthesia time were associated with higher rates of adverse events after TAA.
Despite an increase in the popularity of TAA internationally, the number of TAAs performed remains low in Japan. Lower hospital volume and anesthesia time were associated with higher rates of perioperative adverse events after TAA.
IV, Cross-sectional study
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DOI: 10.1186/s12891-016-1299-x
PubMed: 27793137
PubMed Central: 5084386
Affiliations:
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Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Izawa, Naohiro" sort="Izawa, Naohiro" uniqKey="Izawa N" first="Naohiro" last="Izawa">Naohiro Izawa</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region><settlement type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName></affiliation></author><author><name sortKey="Yasui, Tetsuro" 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type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName></affiliation></author><author><name sortKey="Yasunaga, Hideo" sort="Yasunaga, Hideo" uniqKey="Yasunaga H" first="Hideo" last="Yasunaga">Hideo Yasunaga</name><affiliation wicri:level="4"><nlm:aff id="Aff2">Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region><settlement type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName></affiliation></author><author><name sortKey="Matsui, Hiroki" sort="Matsui, Hiroki" uniqKey="Matsui H" first="Hiroki" last="Matsui">Hiroki Matsui</name><affiliation wicri:level="4"><nlm:aff id="Aff2">Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region><settlement type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName></affiliation></author><author><name sortKey="Fushimi, Kiyohide" sort="Fushimi, Kiyohide" uniqKey="Fushimi K" first="Kiyohide" last="Fushimi">Kiyohide Fushimi</name><affiliation wicri:level="3"><nlm:aff id="Aff3">Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-0034 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Izawa, Naohiro" sort="Izawa, Naohiro" uniqKey="Izawa N" first="Naohiro" last="Izawa">Naohiro Izawa</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region><settlement type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName></affiliation></author><author><name sortKey="Yasui, Tetsuro" sort="Yasui, Tetsuro" uniqKey="Yasui T" first="Tetsuro" last="Yasui">Tetsuro Yasui</name><affiliation wicri:level="1"><nlm:aff id="Aff4">Department of Orthopaedic Surgery, Teikyo University Mizonokuchi Hospital, 3-8-3 Mizonokuchi, Takatsu-ku, Kawasaki, 213-8507 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Orthopaedic Surgery, Teikyo University Mizonokuchi Hospital, 3-8-3 Mizonokuchi, Takatsu-ku, Kawasaki</wicri:regionArea><wicri:noRegion>Kawasaki</wicri:noRegion></affiliation></author><author><name sortKey="Kadono, Yuho" sort="Kadono, Yuho" uniqKey="Kadono Y" first="Yuho" last="Kadono">Yuho Kadono</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region><settlement type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName></affiliation></author><author><name sortKey="Tanaka, Sakae" sort="Tanaka, Sakae" uniqKey="Tanaka S" first="Sakae" last="Tanaka">Sakae Tanaka</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region><settlement type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName></affiliation></author></analytic><series><title level="j">BMC Musculoskeletal Disorders</title><idno type="eISSN">1471-2474</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Total ankle arthroplasty (TAA) has become increasingly popular worldwide as an alternative to ankle arthrodesis for surgical treatment of end-stage ankle arthritis. The aim of this epidemiological study, using a national inpatient database in Japan, was to describe the volume, utilization, patient characteristics, and temporal trends regarding these procedures in Japan, and to identify the risk factors associated with perioperative adverse events in TAA.</p></sec><sec><title>Methods</title><p>This was a population-based, retrospective cohort study. We retrospectively identified 2775 patients in the Diagnosis Procedure Combination database who underwent ankle arthrodesis or TAA for ankle arthritis at 559 hospitals in Japan from 2007 to 2013. Information on sex, age, main diagnosis, use of blood transfusion, duration of anesthesia, length of hospital stay, in-hospital mortality, hospitalization costs, additional procedures after primary surgery, and use of negative pressure wound therapy was extracted. Multivariable logistic regression analysis was performed to analyze the effect of various factors on the incidence of perioperative adverse events in TAA, including additional procedure during hospitalization, negative pressure wound therapy, blood transfusion, and in-hospital death.</p></sec><sec><title>Results</title><p>We identified 465 patients who underwent TAA and 2310 patients who underwent ankle arthrodesis. There was no apparent increase in the proportion of TAAs performed during the survey period. Patients undergoing TAA tended to be older, female, and have rheumatoid arthritis compared with those undergoing ankle arthrodesis. Patients undergoing TAA had shorter length of stay, higher hospitalization costs, and more blood transfusions compared with those undergoing ankle arthrodesis. Lower hospital volume and shorter anesthesia time were associated with higher rates of adverse events after TAA.</p></sec><sec><title>Conclusions</title><p>Despite an increase in the popularity of TAA internationally, the number of TAAs performed remains low in Japan. Lower hospital volume and anesthesia time were associated with higher rates of perioperative adverse events after TAA.</p></sec><sec><title>Level of evidence</title><p>IV, Cross-sectional study</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Zaidi, R" uniqKey="Zaidi R">R Zaidi</name></author><author><name sortKey="Cro, S" uniqKey="Cro S">S Cro</name></author><author><name sortKey="Gurusamy, K" uniqKey="Gurusamy K">K Gurusamy</name></author><author><name sortKey="Siva, N" uniqKey="Siva N">N Siva</name></author><author><name sortKey="Macgregor, A" uniqKey="Macgregor A">A Macgregor</name></author><author><name sortKey="Henricson, A" uniqKey="Henricson A">A Henricson</name></author><author><name sortKey="Goldberg, A" uniqKey="Goldberg A">A Goldberg</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Singh, Ja" uniqKey="Singh J">JA Singh</name></author><author><name sortKey="Ramachandran, R" 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Klauser</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Werner, Bc" uniqKey="Werner B">BC Werner</name></author><author><name sortKey="Burrus, Mt" uniqKey="Burrus M">MT Burrus</name></author><author><name sortKey="Looney, Am" uniqKey="Looney A">AM Looney</name></author><author><name sortKey="Park, Js" uniqKey="Park J">JS Park</name></author><author><name sortKey="Perumal, V" uniqKey="Perumal V">V Perumal</name></author><author><name sortKey="Cooper, Mt" uniqKey="Cooper M">MT Cooper</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Reuver, Jm" uniqKey="Reuver J">JM Reuver</name></author><author><name sortKey="Dayerizadeh, N" uniqKey="Dayerizadeh N">N Dayerizadeh</name></author><author><name sortKey="Burger, B" uniqKey="Burger B">B Burger</name></author><author><name sortKey="Elmans, L" uniqKey="Elmans L">L Elmans</name></author><author><name sortKey="Hoelen, M" uniqKey="Hoelen M">M Hoelen</name></author><author><name sortKey="Tulp, N" uniqKey="Tulp N">N Tulp</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Roukis, Ts" uniqKey="Roukis T">TS Roukis</name></author><author><name sortKey="Prissel, Ma" uniqKey="Prissel M">MA Prissel</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Japon</li></country><region><li>Région de Kantō</li></region><settlement><li>Tokyo</li></settlement><orgName><li>Université de Tokyo</li></orgName></list><tree><country name="Japon"><region name="Région de Kantō"><name sortKey="Matsumoto, Takumi" sort="Matsumoto, Takumi" uniqKey="Matsumoto T" first="Takumi" last="Matsumoto">Takumi Matsumoto</name></region><name sortKey="Fushimi, Kiyohide" sort="Fushimi, Kiyohide" uniqKey="Fushimi K" first="Kiyohide" last="Fushimi">Kiyohide Fushimi</name><name sortKey="Izawa, Naohiro" sort="Izawa, Naohiro" uniqKey="Izawa N" first="Naohiro" last="Izawa">Naohiro Izawa</name><name sortKey="Kadono, Yuho" sort="Kadono, Yuho" uniqKey="Kadono Y" first="Yuho" last="Kadono">Yuho Kadono</name><name sortKey="Matsui, Hiroki" sort="Matsui, Hiroki" uniqKey="Matsui H" first="Hiroki" last="Matsui">Hiroki Matsui</name><name sortKey="Tanaka, Sakae" sort="Tanaka, Sakae" uniqKey="Tanaka S" first="Sakae" last="Tanaka">Sakae Tanaka</name><name sortKey="Yasui, Tetsuro" sort="Yasui, Tetsuro" uniqKey="Yasui T" first="Tetsuro" last="Yasui">Tetsuro Yasui</name><name sortKey="Yasunaga, Hideo" sort="Yasunaga, Hideo" uniqKey="Yasunaga H" first="Hideo" last="Yasunaga">Hideo Yasunaga</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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