-- Mary Elizabeth Dallas
TUESDAY, June 7 (HealthDay News) -- People who have hip or knee
replacement surgery at hospitals that do relatively few surgeries
are at greater risk for serious complications after the procedure,
new research reveals.
Blood clots were more common among patients at hospitals with
low surgical volume, as were deaths within a year of their surgery,
according to the study, published online June 7 in
Arthritis & Rheumatism.
According to the U.S. Centers for Disease Control and
Prevention, about 230,000 total hip replacements and 543,000 total
knee replacements are performed each year in the United States.
"With the large number of elective arthroplasty [joint replacements] in the U.S., it is important to understand the impact of peri- and post-operative medical complications on the success of joint replacement surgery," the study's lead author, Dr. Jasvinder Singh of the University of Alabama, said in a news release from the journal's publisher. "Possible cardiac complications, blood clots or infections increase patient morbidity and mortality risk, which can lead to higher health-care utilization and costs."
For the study, Singh and his fellow researchers compiled data on
10,187 hip and 19,418 knee replacement surgeries performed in
Pennsylvania in 2002. The recipients, who averaged 69 years old,
included more women than men.
People who had a hip replaced at a hospital that did 200 or
fewer surgeries a year were more likely to develop a blood clot
that travels to the lungs, called a pulmonary embolism, within 30
days of surgery than were those who had their surgery at a
high-volume hospital, which did more than 200 surgeries a year.
The risk of dying within a year of the surgery was higher for
people who had total hip replacements at a low-volume hospital and
for those 65 and older who had a total knee replacement at a
hospital with low surgical volume.
The researchers reasoned that the higher risk for complications
at hospitals with low surgical volume may be linked to hospital
procedures, including the prevention and treatment of blood
"Further studies are needed to investigate whether the underlying reasons for poor surgical outcomes at low-volume hospitals are modifiable and which interventions may reduce complications for patients at these facilities," Singh said.
The U.S. National Institute of Arthritis and Musculoskeletal and
Skin Diseases has more on
joint replacement surgery.
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