Maria I Peri, Sarah Whitaker, Sarah Cole, Albert Anastasio, James R Satalich, Conor N O'Neill, Tejas T Patel, James A Nunley, Mark E Easley, Karl M Schweitzer
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Propensity score matching was employed to account for demographic differences, and statistical analyses were performed to compare short-term complication rates between matched cohorts.</p><p><strong>Results: </strong>A total of 2225 patients were identified, with 1432 (64.4%) receiving TAA alone and 793 (35.6%) with ancillary procedure(s). After matching, 793 patients were included in each cohort. The ancillary cohort had longer operative times (<i>P</i> < .001) and length of hospital stay (LOS) (<i>P</i> < 0.001). Rates for extended LOS were significantly higher in the ancillary cohort than in the simple cohort (<i>P</i> = .01). No other complications varied significantly between cohorts, including the incidence of any adverse event (AAE). American Society of Anesthesiologists classification of 4 was found to be an independent risk factor for development of AAE (odds ratio [OR] = 1.091, <i>P</i> = .04). Matched subgroup analysis excluding tendon lengthening as a concomitant procedure found that the ancillary cohort still had longer operative time (<i>P</i> < .001) and LOS (<i>P</i> < .05) than patients undergoing simple TAA.</p><p><strong>Conclusion: </strong>Without significant difference in rates of AAE other than extended LOS, the relative safety of ancillary TAA appears similar to that of TAA alone. Such knowledge can help inform surgical decision-making and assuage safety concerns for patients requiring additional corrective procedures at the time of TAA.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"9 3","pages":"24730114241268150"},"PeriodicalIF":0.0000,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348344/pdf/","citationCount":"0","resultStr":"{\"title\":\"Additional Procedures at the Time of Total Ankle Replacement Do Not Increase Risk of Short-term Complications: A Matched Cohort Analysis.\",\"authors\":\"Maria I Peri, Sarah Whitaker, Sarah Cole, Albert Anastasio, James R Satalich, Conor N O'Neill, Tejas T Patel, James A Nunley, Mark E Easley, Karl M Schweitzer\",\"doi\":\"10.1177/24730114241268150\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This retrospective cohort study compared short-term complication rates following total ankle arthroplasty (TAA), alone or with concomitant procedures. Secondary independent risk factors were also examined as they related to postoperative outcomes.</p><p><strong>Methods: </strong>The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database was queried using <i>Current Procedural Terminology</i> (<i>CPT</i>) codes to identify patients who underwent TAA (27702) between 2010 to 2021. Patients were divided into cohorts based on the presence or absence of ancillary procedures. Propensity score matching was employed to account for demographic differences, and statistical analyses were performed to compare short-term complication rates between matched cohorts.</p><p><strong>Results: </strong>A total of 2225 patients were identified, with 1432 (64.4%) receiving TAA alone and 793 (35.6%) with ancillary procedure(s). After matching, 793 patients were included in each cohort. The ancillary cohort had longer operative times (<i>P</i> < .001) and length of hospital stay (LOS) (<i>P</i> < 0.001). Rates for extended LOS were significantly higher in the ancillary cohort than in the simple cohort (<i>P</i> = .01). No other complications varied significantly between cohorts, including the incidence of any adverse event (AAE). American Society of Anesthesiologists classification of 4 was found to be an independent risk factor for development of AAE (odds ratio [OR] = 1.091, <i>P</i> = .04). Matched subgroup analysis excluding tendon lengthening as a concomitant procedure found that the ancillary cohort still had longer operative time (<i>P</i> < .001) and LOS (<i>P</i> < .05) than patients undergoing simple TAA.</p><p><strong>Conclusion: </strong>Without significant difference in rates of AAE other than extended LOS, the relative safety of ancillary TAA appears similar to that of TAA alone. 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引用次数: 0
摘要
背景：这项回顾性队列研究比较了单独或同时进行全踝关节置换术（TAA）后的短期并发症发生率。研究还考察了与术后结果相关的次要独立风险因素：使用当前程序术语（CPT）代码查询美国外科医生学会（ACS）国家外科质量改进计划（NSQIP）数据库，以确定2010年至2021年间接受TAA（27702）手术的患者。根据有无辅助手术将患者分为不同组群。采用倾向得分匹配法来考虑人口统计学差异，并进行统计分析以比较匹配队列之间的短期并发症发生率：共确定了2225名患者，其中1432人（64.4%）仅接受了TAA，793人（35.6%）接受了辅助手术。经过配对，每个队列中均有 793 名患者。辅助队列的手术时间更长（P P P = .01）。不同组群之间的其他并发症（包括任何不良事件 (AAE) 的发生率）无明显差异。美国麻醉医师协会分级 4 是发生 AAE 的独立风险因素（几率比 [OR] = 1.091，P = .04）。在排除肌腱延长术这一并发症的匹配亚组分析中发现，辅助队列的手术时间仍然更长（P P 结论：除延长 LOS 外，AAE 发生率无明显差异，辅助 TAA 的相对安全性似乎与单独 TAA 相似。这些知识有助于为手术决策提供依据，并减轻在进行 TAA 时需要额外矫正手术的患者对安全性的担忧：III级，回顾性比较研究。
Additional Procedures at the Time of Total Ankle Replacement Do Not Increase Risk of Short-term Complications: A Matched Cohort Analysis.
Background: This retrospective cohort study compared short-term complication rates following total ankle arthroplasty (TAA), alone or with concomitant procedures. Secondary independent risk factors were also examined as they related to postoperative outcomes.
Methods: The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database was queried using Current Procedural Terminology (CPT) codes to identify patients who underwent TAA (27702) between 2010 to 2021. Patients were divided into cohorts based on the presence or absence of ancillary procedures. Propensity score matching was employed to account for demographic differences, and statistical analyses were performed to compare short-term complication rates between matched cohorts.
Results: A total of 2225 patients were identified, with 1432 (64.4%) receiving TAA alone and 793 (35.6%) with ancillary procedure(s). After matching, 793 patients were included in each cohort. The ancillary cohort had longer operative times (P < .001) and length of hospital stay (LOS) (P < 0.001). Rates for extended LOS were significantly higher in the ancillary cohort than in the simple cohort (P = .01). No other complications varied significantly between cohorts, including the incidence of any adverse event (AAE). American Society of Anesthesiologists classification of 4 was found to be an independent risk factor for development of AAE (odds ratio [OR] = 1.091, P = .04). Matched subgroup analysis excluding tendon lengthening as a concomitant procedure found that the ancillary cohort still had longer operative time (P < .001) and LOS (P < .05) than patients undergoing simple TAA.
Conclusion: Without significant difference in rates of AAE other than extended LOS, the relative safety of ancillary TAA appears similar to that of TAA alone. Such knowledge can help inform surgical decision-making and assuage safety concerns for patients requiring additional corrective procedures at the time of TAA.
Level of evidence: Level III, retrospective comparative study.
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