Validation of the Clavien-Dindo classification and Comprehensive Complication Index as measures of morbidity following total hip and knee arthroplasty.

IF 4.9 1区医学 Q1 ORTHOPEDICS

Bone & Joint Journal Pub Date : 2025-01-01 DOI:10.1302/0301-620X.107B1.BJJ-2023-1400.R2

Siddharth Rele, Cade Shadbolt, Chris Schilling, Sharmala Thuraisingam, Jason Trieu, Emma L P Choong, Daniel Gould, Nicholas F Taylor, Michelle M Dowsey, Peter F M Choong

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引用次数: 0

Abstract

Aims: The Clavien-Dindo (CD) classification and Comprehensive Complication Index (CCI) have been validated primarily among general surgical procedures. To date, the validity of these measures has not been assessed in patients undergoing arthroplasty.

Methods: This retrospective cohort study included patients undergoing primary total hip and knee arthroplasty between April 2013 and December 2019. Complications within 90 days of surgery were graded using the CD classification and converted to CCI. Validity was established by assessing the association between both measures and discharge to inpatient rehabilitation, length of stay, and costs.

Results: Among 2,884 patients, 414 (14.4%) had an in-hospital complication and 643 (22.3%) had a complication within 90 days. Each increase in CD grade was associated with USD$1,895.48 (95% CI 1,734.77 to 2,056.18) of additional costs, an additional 1.24 days' length of stay (95% CI 1.15 to 1.33), and 43% (95% CI 26 to 62%) greater odds of discharge to inpatient rehabilitation. Each ten-unit increase in CCI score was associated with USD$1,698.55 (95% CI 1,561.8 to 1,835.3) higher costs, an additional 1.09 days' length of stay (95% CI 1.02 to 1.17), and 33% (95% CI 19% to 49%) greater odds of discharge to inpatient rehabilitation.

Conclusion: Both the CD classification and CCI appear valid and applicable to patients undergoing total joint replacement.

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Clavien-Dindo分类和综合并发症指数作为全髋关节和膝关节置换术后发病率指标的验证。

目的：Clavien-Dindo （CD）分类和综合并发症指数（CCI）主要在普通外科手术中得到验证。迄今为止，这些措施的有效性尚未在接受关节置换术的患者中得到评估。方法：本回顾性队列研究纳入了2013年4月至2019年12月期间接受原发性全髋关节置换术的患者。手术90天内的并发症使用CD分级并转换为CCI。通过评估两种措施与出院至住院康复、住院时间和费用之间的关系来确定有效性。结果：2884例患者中，414例（14.4%）出现院内并发症，643例（22.3%）在90天内出现并发症。每增加一次CD等级，额外费用增加1,895.48美元（95% CI 1,734.77至2,056.18），住院时间增加1.24天（95% CI 1.15至1.33），出院康复的几率增加43% （95% CI 26至62%）。CCI评分每增加10个单位，费用增加1,698.55美元（95% CI 1,561.8至1,835.3），住院时间增加1.09天（95% CI 1.02至1.17），出院康复的几率增加33% （95% CI 19%至49%）。结论：CD分型和CCI对全关节置换术患者均有效，适用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bone & Joint Journal ORTHOPEDICS-SURGERY

CiteScore

9.40

自引率

10.90%

发文量

318

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