Poster Presentations

Start Date

20-5-2014 12:30 PM

Description

Objectives: To measure the association between functional status and an adverse postoperative course.

Design: Retrospective cohort study.

Setting: Veterans Affairs Medical Center.

Participants: Older adults who underwent total hip and knee replacement (THR and TKR) at a VA facility from 2002-2009. To be included, subjects must have completed the Veteran Rand-12 (VR-12) within six months of surgery. VR-12 is a general purpose 12 item health quality survey nearly identical to the SF-12 for which the summary score of physical health called physical component score (PCS) is normed to a value of 50 for US adults with standard deviation of 10.

Measurements: We measured the association of PCS split into quartiles with the outcomes major complication (cardiac arrest, myocardial infarction, stoke, respiratory failure, pneumonia, pulmonary embolism, sepsis, and renal failure), discharge to nursing home, and readmission. We checked our association for confounding by age, race, surgery type, facility volume, duration of time between collection of PCS and surgery, and clustering by facility.

Results: We identified 3,542 THR and TKR surgeries for which PCS information was available. The very lowest quartile of PCS (values 4.9-24.2) predicted a 2.7 fold increase in odds of major complications, 2.1 fold increase in odds of discharge to nursing home, and a 1.9 fold increase in odds of readmission compared with highest quartile (PCS 38.9-61). The next lowest quartile (PCS 24.3-31.8) also predicted elevated rates of major complication and readmission.

Conclusions: Very low PCS predicts greater than a 2 fold increase in major complication and readmission after total hip and knee replacement. Future research should re-measure the effect of very low PCS in populations not addressed by our study including women, patients having non-orthopedic surgery, and nonveterans.

Comments

Abstract of poster presented at the 2014 UMass Center for Clinical and Translational Science Research Retreat, held on May 20, 2014 at the University of Massachusetts Medical School, Worcester, Mass.

Creative Commons License

Creative Commons Attribution-Noncommercial-Share Alike 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 License.

 
May 20th, 12:30 PM

Low Self-Reported Physical Function Status Was an Excellent Predictor of Adverse Postoperative Course in Older Veterans Having Knee and Hip Surgery

Objectives: To measure the association between functional status and an adverse postoperative course.

Design: Retrospective cohort study.

Setting: Veterans Affairs Medical Center.

Participants: Older adults who underwent total hip and knee replacement (THR and TKR) at a VA facility from 2002-2009. To be included, subjects must have completed the Veteran Rand-12 (VR-12) within six months of surgery. VR-12 is a general purpose 12 item health quality survey nearly identical to the SF-12 for which the summary score of physical health called physical component score (PCS) is normed to a value of 50 for US adults with standard deviation of 10.

Measurements: We measured the association of PCS split into quartiles with the outcomes major complication (cardiac arrest, myocardial infarction, stoke, respiratory failure, pneumonia, pulmonary embolism, sepsis, and renal failure), discharge to nursing home, and readmission. We checked our association for confounding by age, race, surgery type, facility volume, duration of time between collection of PCS and surgery, and clustering by facility.

Results: We identified 3,542 THR and TKR surgeries for which PCS information was available. The very lowest quartile of PCS (values 4.9-24.2) predicted a 2.7 fold increase in odds of major complications, 2.1 fold increase in odds of discharge to nursing home, and a 1.9 fold increase in odds of readmission compared with highest quartile (PCS 38.9-61). The next lowest quartile (PCS 24.3-31.8) also predicted elevated rates of major complication and readmission.

Conclusions: Very low PCS predicts greater than a 2 fold increase in major complication and readmission after total hip and knee replacement. Future research should re-measure the effect of very low PCS in populations not addressed by our study including women, patients having non-orthopedic surgery, and nonveterans.

 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.