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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
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Lupus is associated with poorer outcomes after primary total hip arthroplasty

J A Singh1,2,3, J D Cleveland2

  • 11 Medicine Service, Birmingham VA Medical Center, Birmingham, AL, USA.

Lupus
|May 24, 2019
PubMed

Insights

Systemic lupus erythematosus (SLE) is linked to increased risks of implant infection, transfusion, and higher hospital charges after primary total hip arthroplasty (THA). Further research into modifiable factors is recommended to improve patient outcomes.

Area of Science:

  • Orthopedic Surgery
  • Rheumatology
  • Health Services Research

Background:

  • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect multiple organ systems.
  • Total hip arthroplasty (THA) is a common surgical procedure to treat hip osteoarthritis and other hip conditions.
  • The impact of SLE on outcomes following primary THA requires further investigation.

Purpose of the Study:

  • To determine if patients with SLE experience poorer outcomes after primary total hip arthroplasty (THA).
  • To assess the association between SLE and specific post-operative complications and healthcare utilization after THA.

Main Methods:

  • Utilized the US National Inpatient Sample (NIS) database from 1998-2014.
  • Employed multivariable-adjusted logistic regression models to analyze associations.
  • Adjusted for demographics, comorbidities, insurance, and hospital characteristics.

Main Results:

  • Among over 4.1 million primary THA hospitalizations, 0.5% involved patients with SLE.
  • SLE was associated with a significantly higher risk of implant infection (OR 1.95), transfusion (OR 1.34), discharge to an inpatient facility (OR 1.21), and higher hospital charges.
  • No significant association was found between SLE and revision surgery, mortality, or prolonged hospital stay (>3 days).

Conclusions:

  • SLE is associated with increased risks of specific adverse outcomes and higher healthcare costs following primary THA.
  • Identifying and addressing modifiable factors may enhance outcomes for SLE patients undergoing THA.
Abstract

Keywords:
Arthroplastyhip replacementmusculoskeletaloutcomessystemic lupus erythematosus

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