Postoperative Complications and Readmission Rates in Robotic-Assisted and Manual Total Hip Arthroplasty: A Large, Multi-Hospital Study.

IF 2.8 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Medical Care Pub Date : 2025-07-01 Epub Date: 2024-10-24 DOI:10.1097/MLR.0000000000002082

Cole Howell, Sietske Witvoet, Laura Scholl, Andrea Coppolecchia, Manoshi Bhowmik-Stoker, Antonia F Chen

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引用次数: 0

Abstract

Objective: This study aims to compare 90-day postoperative complications, readmissions, and emergency department (ED) visits between robotic-assisted (RA-THA) and manual (M-THA) total hip arthroplasty.

Methods: A retrospective review of a multi-hospital database identified primary total hip arthroplasty patients between January 2016 and December 2021. The cohorts were 1-to-1 matched based on patient sex, age, and body mass index resulting in 8033 patients in each cohort (N = 16,066). Odds of 90-day revisits, readmission with >23 hours of observation, and ED visits were compared between cohorts. Complications reported during revisits and readmission were classified according to the Clinical Classification Software schema, using the International Classification of Diseases, 10th Revision codes, and compared using mixed-effect models.

Results: This study found an overall 90-day revisit rate of 8.3%. RA-THA was associated with significantly reduced odds of revisit within 90 days [odds ratio (OR): 0.71, 95% CI: 0.58-0.89, P = 0.002] and readmissions with >23 hours of observation (OR: 0.61, 95% CI: 0.48-0.77, P < 0.001). RA-THA patients had fewer readmissions with >23 hours of observation due to dislocations (RA-THA: 0.09%; M-THA: 0.39%, P < 0.001), surgical site infections (RA-THA: 0.04%; M-THA: 0.20%, P = 0.004), and wound infections/cellulitis (RA-THA: 0.01%; M-THA: 0.11%, P = 0.021). No difference in ED visits was observed between cohorts (OR: 0.92, 95% CI: 0.77-1.09, P = 0.3). RA-THA patients had more ED visits for dyspnea without pulmonary embolism (RA-THA: 0.20%; M-THA: 0.06%, P = 0.03).

Conclusion: RA-THA showed significantly lower odds of overall 90-day revisit rates and readmissions with >23 hours of observation, most notably for readmissions due to dislocation and surgical site infection/wound infections. There was no significant difference in the odds of ED visits between cohorts.

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机器人辅助和人工全髋关节置换术的术后并发症和再入院率：一项大型、多医院研究。

目的：本研究旨在比较机器人辅助（RA-THA）和人工（M-THA）全髋关节置换术后90天的并发症、再入院和急诊（ED）就诊情况。方法：对2016年1月至2021年12月间的多医院数据库进行回顾性分析，确定了原发性全髋关节置换术患者。根据患者性别、年龄和体重指数进行1对1匹配，每个队列中有8033例患者（N = 16066）。比较各组患者90天复诊率、观察23小时后再入院率和急诊科复诊率。复诊和再入院期间报告的并发症根据临床分类软件方案进行分类，使用国际疾病分类第10版代码，并使用混合效应模型进行比较。结果：本研究发现总体90天重访率为8.3%。RA-THA与90天内重访的几率显著降低相关[比值比（OR）： 0.71, 95% CI: 0.58-0.89, P = 0.002]，与观察后23小时再入院的几率显著降低相关（OR: 0.61, 95% CI: 0.48-0.77, P < 0.001）。RA-THA患者因脱位而再次入院的人数较少，观察时间为bbbb23小时(RA-THA: 0.09%；M-THA: 0.39%, P < 0.001)，手术部位感染(RA-THA: 0.04%；M-THA: 0.20%, P = 0.004)，伤口感染/蜂窝织炎(RA-THA: 0.01%；m = 0.11%, p = 0.021)。各组患者急诊室就诊次数无差异（OR: 0.92, 95% CI: 0.77-1.09, P = 0.3）。RA-THA患者因呼吸困难而无肺栓塞的ED就诊较多(RA-THA: 0.20%；m = 0.06%, p = 0.03)。结论：RA-THA在观察bbb23小时时显示总体90天重访率和再入院率显著降低，尤其是脱位和手术部位感染/伤口感染引起的再入院。在队列之间，急诊科就诊的几率没有显著差异。

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

Medical Care 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

3.30%

发文量

228

审稿时长

3-8 weeks

期刊介绍： Rated as one of the top ten journals in healthcare administration, Medical Care is devoted to all aspects of the administration and delivery of healthcare. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of healthcare. This timely journal reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services.