初次全肩关节置换术后,再次找同一位外科医生进行全肩关节置换术的相关因素。

IF 2 Q2 ORTHOPEDICS
Michael J Gouzoulis, Scott J Halperin, Anthony E Seddio, Christopher Wilhelm, Jay Moran, Kenneth W Donohue, Andrew E Jimenez, Jonathan N Grauer
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引用次数: 0

摘要

背景:全肩关节置换术(TSA)通常用于治疗退行性病变。患者可能需要额外的对侧 TSA 或同侧翻修 TSA。作为患者满意度和诊疗完整性的标志,患者再次选择同一或不同外科医生的相关因素值得关注:方法:从PearlDiver数据集中抽取接受TSA手术的患者。方法:从 PearlDiver 数据集中摘录了接受 TSA 的患者,并对 2 年内再次接受 TSA 的患者进行了识别。分析的因素包括年龄、性别、合并症负担、既往抑郁症诊断、保险类型、反向TSA与解剖TSA、同侧手术与对侧手术以及术后不良事件。通过多变量分析比较了返回同一外科医生与不同外科医生的患者:共发现98048名TSA患者,其中8483名患者(8.7%)在2年内接受了后续TSA手术。其中有1237人(14.6%)选择了不同的外科医生。与更换外科医生相关的因素包括同侧肩部的翻修手术(OR:2.47)、医疗补助保险(OR:1.46)、女性(OR:1.36)、任何不良事件(OR:1.23)和较高的Elixhauser合并症指数(OR:1.07/点),而之前的抑郁症诊断与更换外科医生的几率降低(OR:0.74)相关(所有因素的P<0.05):讨论:在寻求后续TSA时,只有少数患者更换了外科医生。已发现的与更换外科医生相关的因素可能有助于指导提高患者满意度和诊疗完整性的措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
After Primary Total Shoulder Arthroplasty, Factors Associated with Returning to the Same Surgeon for Subsequent Total Shoulder Arthroplasty.

Background: Total shoulder arthroplasty (TSA) is commonly done for degenerative conditions. Patients may need additional contralateral TSA or ipsilateral revision TSA. As a marker of patient satisfaction and practice integrity, factors associated with return to the same or different surgeon are of interest.

Methods: Patients undergoing TSA were abstracted from the PearlDiver data set. Subsequent TSA within 2 years was identified. Factors analyzed included age, sex, comorbidity burden, prior depression diagnosis, insurance type, reverse versus anatomic TSA, ipsilateral versus contralateral surgery, and postoperative adverse events. Patients returning to the same surgeon versus different surgeon were compared with multivariable analysis.

Results: 98,048 TSA patients were identified, with 8483 patients (8.7%) undergoing subsequent TSA within 2 years. Of those, 1,237 (14.6%) chose a different surgeon. Factors associated with changing surgeons were revision surgery on the ipsilateral shoulder (OR:2.47), Medicaid insurance (OR:1.46), female sex (OR:1.36), any adverse events (OR:1.23), and higher Elixhauser Comorbidity Index (OR:1.07 per point), while prior depression diagnosis was associated with decreased odds (OR:0.74) of changing surgeon (P < 0.05 for all).

Discussion: When pursuing a subsequent TSA, only a minority of patients changed to a different surgeon. Factors identified associated with changing to a different surgeon may help guide measures to improve patient satisfaction and practice integrity.

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来源期刊
CiteScore
2.60
自引率
6.70%
发文量
282
审稿时长
8 weeks
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