Representativeness of participants in the Danish National Health Survey across 422,371 orthopedic surgeries: a study of hip and knee arthroplasty and hip fracture patients

Aims

Orthopedic registries have provided valuable knowledge about risk for and prognosis after total hip arthroplasties (THA), knee arthroplasties (KA), and hip fractures. However, registries are often limited by the lack of data on health risk behaviors, quality of life, and social background, which are readily available in surveys. We examined if participants in The Danish National Health Survey, based on self-administered questionnaires, are representative of THA, KA, and hip fracture patients.

Methods

Patients were identified in the Danish orthopedic registries and linked with survey data (from 2010, 2013, and 2017) on an individual level. Data on age, sex, comorbidity, medication, markers of socioeconomic position, and healthcare utilization were assessed from the Danish medical databases. We calculated the proportions of variables before and after surgery, comparing patients who had and had not participated in surveys.

Results

We included 177,617 THA surgeries (4.5% of patients completed pre-surgery surveys and 7.0% completed post-surgery surveys), 152,154 KA surgeries (7.0% of patients completed pre-surgery surveys and 6.2% completed post-surgery surveys) and 92,600 hip fracture surgeries (3.8% of patients completed pre-surgery surveys and 2.2% completed post-surgery surveys). Survey participants and non-participants had similar age and sex distribution in the three cohorts. Based on comorbidity, medication, and healthcare utilization, participants appeared slightly healthier than non-participants. There was a slight variation in socioeconomic markers for THA and KA patients between participants and non-participants.

Conclusion

The Danish National Health Survey provides a sample that appears to be largely representative of all THA, KA, and hip fracture patients in Denmark. Survey data could be a valuable data source for further studies of the risks and outcomes associated with patients undergoing THA and KA and those suffering from hip fractures, while carefully considering the identified similarities and differences when designing studies and analyzing the survey data.