TY - JOUR
T1 - Total hip arthroplasty in patients with colostomy
T2 - impact on inpatient complications, hospital costs, and length of stay
AU - Yang, Kristine
AU - Sambandam, Senthil
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2024/1
Y1 - 2024/1
N2 - Introduction: The presence of permanent end-colostomy is traditionally thought of as a risk factor for complications following orthopedic joint replacement; however, literature supporting this association is scarce. This study aims to discern how length of stay, cost of stay, and inpatient complications following total hip arthroplasty (THA) are impacted by presence of colostomy. Methods: Data from the National Inpatient Sample was analyzed by International Classification of Diseases, 10th Revision, Clinical Modification regarding THA in patients with and without end-colostomy. Unmatched and matched analyses comparing length of stay, cost of stay, and post-operative adverse outcomes between the two groups were conducted. In the unmatched analysis, 445 THA patients with colostomy were compared to 367,449 THA patients without colostomy. The colostomy patients were then matched for age, sex, race, diabetes, obesity, and the matched groups consisted of 445 patients with and 425 patients without colostomy, respectively. Results: Compared to the THA without colostomy group, the colostomy group was significantly older, had longer hospital stays, and greater cost of stay. When matched for age and comorbidities, length of hospital stay (p < 0.001) and cost of stay (p = 0.002) remained significantly higher. The colostomy group was at significantly increased risk for periprosthetic fracture, dislocation, and infection compared to all THA patients. When matched for age and common comorbidities, the colostomy group had significantly higher risk in only periprosthetic dislocation [p = 0.003, OR 11.8 (1.6–4.6, 95% CI)] and periprosthetic infection [p < 0.05, OR 2.7 (0.97–7.7 95% CI)]. Conclusion: Patients with colostomy are at risk of longer hospital courses and greater incurred costs following THA compared to patients without colostomy. They are additionally at significantly increased risk of periprosthetic dislocation and periprosthetic infection, warranting treatment as high-risk patients. Study design: Retrospective cohort study.
AB - Introduction: The presence of permanent end-colostomy is traditionally thought of as a risk factor for complications following orthopedic joint replacement; however, literature supporting this association is scarce. This study aims to discern how length of stay, cost of stay, and inpatient complications following total hip arthroplasty (THA) are impacted by presence of colostomy. Methods: Data from the National Inpatient Sample was analyzed by International Classification of Diseases, 10th Revision, Clinical Modification regarding THA in patients with and without end-colostomy. Unmatched and matched analyses comparing length of stay, cost of stay, and post-operative adverse outcomes between the two groups were conducted. In the unmatched analysis, 445 THA patients with colostomy were compared to 367,449 THA patients without colostomy. The colostomy patients were then matched for age, sex, race, diabetes, obesity, and the matched groups consisted of 445 patients with and 425 patients without colostomy, respectively. Results: Compared to the THA without colostomy group, the colostomy group was significantly older, had longer hospital stays, and greater cost of stay. When matched for age and comorbidities, length of hospital stay (p < 0.001) and cost of stay (p = 0.002) remained significantly higher. The colostomy group was at significantly increased risk for periprosthetic fracture, dislocation, and infection compared to all THA patients. When matched for age and common comorbidities, the colostomy group had significantly higher risk in only periprosthetic dislocation [p = 0.003, OR 11.8 (1.6–4.6, 95% CI)] and periprosthetic infection [p < 0.05, OR 2.7 (0.97–7.7 95% CI)]. Conclusion: Patients with colostomy are at risk of longer hospital courses and greater incurred costs following THA compared to patients without colostomy. They are additionally at significantly increased risk of periprosthetic dislocation and periprosthetic infection, warranting treatment as high-risk patients. Study design: Retrospective cohort study.
KW - Colostomy
KW - Total hip arthroplasty
KW - Total hip arthroplasty with colostomy
KW - Total hip arthroplasty with end colostomy
KW - Total hip replacement
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U2 - 10.1007/s00402-023-05060-0
DO - 10.1007/s00402-023-05060-0
M3 - Article
C2 - 37755481
AN - SCOPUS:85173006592
SN - 0936-8051
VL - 144
SP - 509
EP - 516
JO - Archives of Orthopaedic and Trauma Surgery
JF - Archives of Orthopaedic and Trauma Surgery
IS - 1
ER -