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Hip arthroscopy utilization and associated complications: a population-based analysis

机译:髋关节镜利用率和相关并发症:基于人群的分析

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摘要

The purpose of this study is to review the trends in hip arthroscopy using data from a statewide database, focusing on utilization rates, patient demographics and complication rates. The Statewide Planning and Research Cooperative System (SPARCS) database for New York State was queried for cases of hip arthroscopy from 1998 to 2012. Patient demographics and procedural details were collected. Patients were subsequently reviewed for complications and readmissions within 30 and 90 days. In total, 12 194 hip arthroscopy procedures were performed by 295 surgeons in 137 centers between 1998 and 2012. There was a 95-fold increase in the annual frequency of hip arthroscopy procedures between 1998 (n = 24) and 2012 (n = 2296). Thirty-day complication rates were 0.2% (n = 19), whereas the 90-day complication rate was 0.3% (n = 30). The all-cause 30-day readmission rate was 0.5% (n = 66), whereas the 90-day rate was 1.6% (n = 200). The number of surgeons performing hip arthroscopy increased 7-fold over the observation period. However, only 14.9% (n = 44) of surgeons performed more than 30 procedures annually. Lower volume surgeons (<102 cases/year) demonstrated significantly higher 90-day readmission rates, compared with higher volume surgeons (>163 cases/year, P < 0.0060); however, complication rates and readmission rates did not differ based on surgeon volume. Our findings confirm our hypothesis, demonstrating a significant increase in utilization of hip arthroscopy in the State of New York. We did not identify an associated increase in annual complication rates as hypothesized with increasing utilization, although there was an association of higher readmission rates among lower volume surgeons. Further study is needed to define rates of failure requiring revision hip arthroscopy or conversion to arthroplasty, and to clarify the relationship between complication rates and surgeon volume and case complexity. Level of Evidence: III, retrospective cohort series.
机译:这项研究的目的是使用来自全州数据库的数据来回顾髋关节镜检查的趋势,重点是利用率,患者人口统计学和并发症发生率。查询纽约州的州计划与研究合作系统(SPARCS)数据库,以了解其1998年至2012年的髋关节镜检查病例。收集了患者的人口统计资料和程序细节。随后在30和90天内对患者进行了并发症和再次入院的检查。在1998年至2012年期间,共有295位外科医生在137个中心进行了12 194次髋关节镜检查手术。在1998年(n = 24)和2012年(n = 2296)之间,髋关节镜检查手术的年频率增加了95倍。 。 30天并发症发生率为0.2%(n = 19),而90天并发症发生率为0.3%(n = 30)。 30天的全因入学率为0.5%(n = 66),而90天的入学率为1.6%(n = 200)。在观察期内,进行髋关节镜检查的外科医生人数增加了7倍。但是,每年只有14.9%(n = 44)的外科医生执行了30多次手术。较低数量的外科医生(<102例/年)表现出更高的90天再入院率,而较高数量的外科医生(> 163例/年,P <0.0060);然而,并发症的发生率和再入院率并没有因医生的体型而异。我们的发现证实了我们的假设,表明在纽约州,髋关节镜的使用率显着增加。我们没有发现假说与利用率的增加相关的年度并发症发生率的增加,尽管在较低容量的外科医生中有较高的再入院率。需要进一步的研究来确定需要翻修髋关节镜或转换为关节置换术的失败率,并阐明并发症发生率与外科医生人数和病例复杂性之间的关系。证据水平:III,回顾性队列研究。

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