How Do Preoperative Medications Influence Outcomes After Total Joint Arthroplasty?

Abstract Background Recent health care policy changes require hospitals and physicians to demonstrate improved quality. In 2012, a prospective database was formed with the Blue Cross and Blue Shield of Michigan to improve quality of care. The purpose of this study was to analyze patient preoperative...

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Bibliographic Details
Published in:The Journal of arthroplasty 2017-09, Vol.32 (9), p.S259-S262
Main Authors: Zarling, Bradley J., MD, Sikora-Klak, Jakub, MD, Bergum, Chris, BS, Markel, David C., MD
Format: Article
Language:English
Subjects:
Aged
Anti-Infective Agents - adverse effects
Anticoagulants - adverse effects
Arthroplasty, Replacement, Hip - adverse effects
Arthroplasty, Replacement, Hip - methods
Arthroplasty, Replacement, Knee - adverse effects
Arthroplasty, Replacement, Knee - methods
Databases, Factual
Female
Humans
Hypoglycemic Agents - adverse effects
Insulin - adverse effects
Length of Stay
Male
MARCQI
Michigan
Michigan Arthroplasty Registry Collaborative Quality Initiative
Middle Aged
Narcotics - adverse effects
Orthopedics
Patient Discharge
Patient Readmission
Platelet Aggregation Inhibitors - adverse effects
preoperative medications
Preoperative Period
Prospective Studies
Quality Improvement
Skilled Nursing Facilities
Steroids - adverse effects
total joint arthroplasty
Treatment Outcome
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Summary:Abstract Background Recent health care policy changes require hospitals and physicians to demonstrate improved quality. In 2012, a prospective database was formed with the Blue Cross and Blue Shield of Michigan to improve quality of care. The purpose of this study was to analyze patient preoperative medication as predictors of outcomes after total joint arthroplasty. Methods Data were collected on patient's preoperative medications from 2012 to 2015 using a total joint arthroplasty database. Medications were categorized as antiplatelet, antimicrobial, anticoagulant, narcotic, steroid, insulin, or oral diabetes medication. Outcomes included hospital length of stay (LOS), discharge disposition/destination, and 90-day readmission. Univariate and multivariate regression analyses were performed. Results A total of 3959 patients were studied. Eighty percent (3163 patients) were discharged home. The remainder (795) went to an extended-care facility (ECF). Patients discharged to an ECF were taking more medications (1.13 vs 0.80 in total knee arthroplasty; 1.18 vs 0.83 in total hip arthroplasty; P
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2017.04.031