We have located links that may give you full text access.
Demographic and Socioeconomic Trends of Patients Undergoing Total Knee Arthroplasty from 2013 to 2022 - An Analysis from an Urban Orthopaedic Hospital.
Journal of Arthroplasty 2024 April 12
INTRODUCTION: As worldwide utilization of total knee arthroplasty (TKA) broadens, demographic trends can help make projections to inform access to care. This study aimed to assess the temporal trends in the socioeconomic and medical demographics of patients undergoing TKA.
METHODS: A retrospective review of 15,848 patients who underwent primary, elective TKA at an urban, New York City-based, academic medical center between January 2013 and September 2022 was performed. Trends in patients' age, body mass index (BMI), socioeconomic status (SES) (based on median income by patients' ZIP code), race, and Charlson comorbidity index (CCI) were evaluated using the Mann-Kendall test.
RESULTS: In the last decade, mean patient age (65 to 68 years, P < 0.001) and CCI (1.4 to 2.3, P < 0.001) increased significantly. The proportion of patients who had a BMI ≥ 30 and < 40 increased (43.8 to 51.2%, P = 0.002), while the proportion of patients who had a BMI ≥ 40 (13.7 to 12.1%, P = 0.015) and BMI < 30 (42.5 to 36.8%, P = 0.020) decreased. The distribution of patients' race and SES did not change from 2013 to 2022; Black (18.1 to 16.8%, P = 0.211) and low SES (12.9 to 11.3%, P = 0.283) patients consistently represented a minority of TKA patients.
CONCLUSIONS: Over the last decade, the average age and comorbidity burden of TKA patients at our institution have increased. This portends the need for higher levels of preoperative optimization and postoperative management for TKA patients. A decreased prevalence of BMI ≥ 40 could reflect optimization efforts. However, the consistently low prevalence of Black and low-SES patients suggests that recent payment models did not improve access to care for these populations.
METHODS: A retrospective review of 15,848 patients who underwent primary, elective TKA at an urban, New York City-based, academic medical center between January 2013 and September 2022 was performed. Trends in patients' age, body mass index (BMI), socioeconomic status (SES) (based on median income by patients' ZIP code), race, and Charlson comorbidity index (CCI) were evaluated using the Mann-Kendall test.
RESULTS: In the last decade, mean patient age (65 to 68 years, P < 0.001) and CCI (1.4 to 2.3, P < 0.001) increased significantly. The proportion of patients who had a BMI ≥ 30 and < 40 increased (43.8 to 51.2%, P = 0.002), while the proportion of patients who had a BMI ≥ 40 (13.7 to 12.1%, P = 0.015) and BMI < 30 (42.5 to 36.8%, P = 0.020) decreased. The distribution of patients' race and SES did not change from 2013 to 2022; Black (18.1 to 16.8%, P = 0.211) and low SES (12.9 to 11.3%, P = 0.283) patients consistently represented a minority of TKA patients.
CONCLUSIONS: Over the last decade, the average age and comorbidity burden of TKA patients at our institution have increased. This portends the need for higher levels of preoperative optimization and postoperative management for TKA patients. A decreased prevalence of BMI ≥ 40 could reflect optimization efforts. However, the consistently low prevalence of Black and low-SES patients suggests that recent payment models did not improve access to care for these populations.
Full text links
Related Resources
Trending Papers
Review article: Recent advances in ascites and acute kidney injury management in cirrhosis.Alimentary Pharmacology & Therapeutics 2024 March 26
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app