Clinical Orthopaedics and Related Research®最新文献

{"title":"Frailty Is Associated With Increased 30-day Readmissions and Costs After Total Shoulder Arthroplasty.","authors":"Akshay Lakra,Nyi-Rein Kyaw,James M Puleo,Michael C Kuna,Michael Tram,Joseph P Zimmerman","doi":"10.1097/corr.0000000000003461","DOIUrl":"https://doi.org/10.1097/corr.0000000000003461","url":null,"abstract":"BACKGROUNDFrailty has been associated with a greater risk of complications and higher treatment costs for various medical conditions and surgical procedures. The Modified Frailty Index, which analyzes five or six medical comorbidities, helps grade the severity of a patient's frailty. Patients with frailty, as recognized by this index, are more likely to face adverse medical and surgical events after total shoulder arthroplasty (TSA). However, these modified indices often do not consider less common medical conditions that contribute to frailty. As such, we believe that patients may be more readily misdiagnosed as not having frailty. A more comprehensive frailty score that more accurately recognizes frailty in a wider patient population is necessary.QUESTION/PURPOSESAfter analyzing for any possible differences due to confounding variables such as age, gender, socioeconomic variables, and insurance provider, we asked: (1) Was frailty, defined as a score of ≥ 5 on the Hospital Frailty Risk Score (HFRS), associated with a higher risk of reoperation or readmission within 30 days of primary TSA? (2) Was frailty associated with an increased risk of major medical or surgical complications after TSA? (3) Was frailty associated with higher hospital costs (assessed by insurance charge-to-cost ratio per admission) and length of stay for patients after TSA?METHODSThis study examined the Nationwide Readmissions Database, which includes patients from 28 states, representing 60% of all US residents and 60% of all US hospitalizations. We identified adult patients who were discharged after both anatomic and reverse TSA for primary osteoarthritis between January and November of 2017 to 2019 (patients who underwent TSA in December of each year were excluded). The HFRS was calculated for each patient based on 109 differently weighted ICD-10 Clinical Modification codes as validated in previous studies. Patients with an HFRS of ≥ 5 were considered as having frailty. Of the 107,774 patients who underwent TSA and were recorded in this database, 15% (16,210) were classified as patients with frailty. Patients over age 65 years comprised a larger portion of patients with frailty than patients without frailty (81% [13,130 of 16,210] of patients with frailty versus 74% [67,757 of 91,564] of patients without frailty; p < 0.01). Women comprised a larger portion of patients with frailty than patients without frailty (62% [10,050 of 16,210] women with frailty versus 53% [48,528 of 91,564] women without frailty; p < 0.01). Patients paying with Medicare comprised a larger portion of patients with frailty than patients without frailty (80% [12,968 of 16,210] Medicare payers with frailty versus 72% [65,926 of 91,564] Medicare payers without frailty; p < 0.01). We used the Student t-test to compare demographics and complication risk. After analysis of these confounders and controlling for them, we used multivariate logistic regression to analyze 30-day readmissions and negative binomi","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"17 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Coming Back to Work After a Wrong-site Surgical Procedure.","authors":"M Daniel Wongworawat","doi":"10.1097/corr.0000000000003465","DOIUrl":"https://doi.org/10.1097/corr.0000000000003465","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"116 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Dr. AI Will See You Now\": How Do ChatGPT-4 Treatment Recommendations Align With Orthopaedic Clinical Practice Guidelines?","authors":"Lin Po-Chun,Zhi-Hong Zheng","doi":"10.1097/corr.0000000000003417","DOIUrl":"https://doi.org/10.1097/corr.0000000000003417","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"108 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to the Letter to the Editor: \"Dr. AI Will See You Now\": How Do ChatGPT-4 Treatment Recommendations Align With Orthopaedic Clinical Practice Guidelines?","authors":"Tanios Dagher,Jason Strelzow","doi":"10.1097/corr.0000000000003455","DOIUrl":"https://doi.org/10.1097/corr.0000000000003455","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"218 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: On Patient Safety: It Is Time to Rethink Gabapentin.","authors":"T Desmond Brown","doi":"10.1097/corr.0000000000003440","DOIUrl":"https://doi.org/10.1097/corr.0000000000003440","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"1 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: On Patient Safety: It Is Time to Rethink Gabapentin.","authors":"Ethan Lichtblau","doi":"10.1097/corr.0000000000003441","DOIUrl":"https://doi.org/10.1097/corr.0000000000003441","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"6 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORR Insights®: Can Surgeons or Patients Predict the Likelihood of Improvement With Nonoperative Treatment of Chronic Tennis Elbow?","authors":"Pedro K Beredjiklian","doi":"10.1097/CORR.0000000000003488","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003488","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to the Letter to the Editor: Arthroscopic Partial Meniscectomy for a Degenerative Meniscus Tear Is Not Cost Effective Compared With Placebo Surgery: An Economic Evaluation Based on the FIDELITY Trial Data.","authors":"Teppo L N Järvinen","doi":"10.1097/corr.0000000000003483","DOIUrl":"https://doi.org/10.1097/corr.0000000000003483","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"16 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to the Letter to the Editor: On Patient Safety: It Is Time to Rethink Gabapentin.","authors":"James Rickert","doi":"10.1097/corr.0000000000003492","DOIUrl":"https://doi.org/10.1097/corr.0000000000003492","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"246 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORR Insights®: Leptin Enhances M1 Macrophage Polarization and Impairs Tendon-Bone Healing in Rotator Cuff Repair: A Rat Model.","authors":"Xudong Joshua Li","doi":"10.1097/corr.0000000000003474","DOIUrl":"https://doi.org/10.1097/corr.0000000000003474","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"39 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}