Assessing Preoperative Risk Factors With Sex Disparities in Total Joint Arthroplasty Patients and Financial Outcomes...

Area of Science:

• Orthopedic Surgery
• Health Services Research
• Epidemiology

Background:

• Healthcare disparities can negatively impact vulnerable populations.
• Total joint arthroplasty (TJA) is underutilized, particularly in women, despite its success in treating end-stage arthritis.
• Limited understanding exists regarding preoperative clinical and demographic differences between sexes undergoing TJA.

Purpose of the Study:

• To conduct a population-based assessment of preoperative risk factors and sex disparities in TJA.
• To evaluate differences in TJA outcomes between male and female patients.

Main Methods:

• Analysis of the National Inpatient Sample database (2006-2011).
• Identification and stratification of patients undergoing primary total knee and hip arthroplasty into male and female cohorts.
• Collection of demographic data, comorbidities, and measurement of postoperative complications, length of stay, charges, and discharge destination.

Main Results:

• Female patients undergoing TJA were older and more likely to have anemia, autoimmune disorders, COPD, depression, obesity, and valvular disease.
• Female patients had a longer average length of stay (3.52 vs. 3.39 days) and a lower home discharge rate (59% vs. 73%).
• Female patients experienced a higher overall odds of in-patient complications.

Conclusions:

• Significant sex differences in preoperative profiles and postoperative outcomes exist for TJA patients.
• These disparities may contribute to the underuse of TJA, especially among women.
• Addressing these unmet needs requires further research and provider education to ensure equitable access to TJA for pain relief and functional improvement.