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Juvenile idiopathic arthritis is associated with higher healthcare utilization after total knee or hip replacement

J A Singh1,2,3, J D Cleveland2

  • 1Medicine Service, VA Medical Center , Birmingham, AL, USA.

Scandinavian Journal of Rheumatology
|July 16, 2020
PubMed

Insights

Juvenile idiopathic arthritis (JIA) patients undergoing hip or knee replacement surgery experienced higher healthcare costs and longer hospital stays. Patients with JIA also had increased odds of requiring transfusions after knee replacement surgery.

Area of Science:

  • Orthopedic Surgery
  • Rheumatology
  • Health Services Research

Background:

  • Juvenile idiopathic arthritis (JIA) is a chronic inflammatory condition affecting children.
  • The long-term impact of JIA on adult outcomes after major orthopedic procedures like total hip or knee arthroplasty (THA/TKA) is not well understood.

Purpose of the Study:

  • To investigate the association between JIA and healthcare utilization and in-hospital complications following THA/TKA.
  • To identify potential disparities in resource use and adverse events in JIA patients undergoing arthroplasty.

Main Methods:

  • Utilized the US National Inpatient Sample (1998-2014) for a large-scale retrospective analysis.
  • Employed multivariable-adjusted logistic regression to compare outcomes between patients with and without JIA, controlling for demographic and clinical factors.

Main Results:

  • Patients with JIA undergoing THA/TKA showed significantly higher odds of exceeding median hospital charges and length of stay.
  • JIA patients had increased odds of discharge to non-home settings after THA.
  • A higher odds ratio for blood transfusion was observed in JIA patients post-TKA.

Conclusions:

  • Juvenile idiopathic arthritis is linked to increased healthcare resource utilization after total hip and knee arthroplasty.
  • Patients with JIA demonstrate a higher likelihood of requiring transfusions post-TKA.
  • Targeted interventions may be necessary to mitigate elevated resource utilization in JIA patients undergoing arthroplasty.

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