Abstract
BackgroundTo assess whether Sjogren’s Syndrome (SS) is associated with outcomes after total knee or hip arthroplasty (TKA/THA).MethodsWe used the 1998–2014 U.S. National Inpatient Sample data. We performed multivariable-adjusted logistic regression analyses to assess the association of SS with healthcare utilization (hospital charges, length of hospital stay, discharge to non-home setting), and in-hospital complications (implant infection, revision, transfusion, mortality), controlling for important covariates and confounders. In sensitivity analyses, we additionally adjusted the main models for hospital location/teaching status, bed size, and region.ResultsWe examined 4,116,485 primary THAs and 8,127,282 primary TKAs performed from 1998 to 2014; 12,772 (0.2%) primary TKAs and 6222 (0.2%) primary THAs were done in people with SS. In multivariable-adjusted models, SS was associated with a statistically significant higher odds ratio (OR; 95% confidence interval (CI)) of discharge to a rehabilitation/inpatient facility post-THA, 1.13 (1.00, 1.28), but not post-TKA, 0.93 (0.86, 1.02). We noted no differences in the length of hospital stay or hospital charges. SS was associated with significantly higher adjusted odds of in-hospital transfusion post-THA, 1.37 (1.22, 1.55) and post-TKA, 1.21 (1.10, 1.34). No significant differences by SS diagnosis were seen in hospital stay, hospital charges implant infection, implant revision or mortality rates.ConclusionsPeople with SS had higher transfusion rate post-TKA/THA, and higher rate of discharge to non-home setting post-THA. The lack of association of SS with post-arthroplasty complications should reassure patients, surgeons and policy-makers about the utility of TKA/THA in people with SS undergoing these procedures.
Highlights
To assess whether Sjogren’s Syndrome (SS) is associated with outcomes after total knee or hip arthroplasty (TKA/Total hip arthroplasty (THA))
Of the 4,116,485 primary THAs and 8,127,282 primary Total knee arthroplasty (TKA) performed from 1998 to 2014, 12,772 (0.2%) primary TKAs and 6222 (0.2%) primary THAs were done in people with SS
SS was associated with a higher risk of transfusion after THA and TKA, at 1.2–1.4 fold higher
Summary
To assess whether Sjogren’s Syndrome (SS) is associated with outcomes after total knee or hip arthroplasty (TKA/THA). Sjogren’s Syndrome (SS) is a systemic autoimmune disease, primarily of middle-aged women, characterized by dry eyes, dry mouth and systemic symptoms [1]. With the aging of the population, an increasing number of people with SS and the general population are undergoing joint arthroplasty. Total knee arthroplasty (TKA) or hip arthroplasty (THA) are the two most common arthroplasty surgeries performed for end-stage arthritis [4]. Complications and healthcare utilization after arthroplasty are increased in other systemic inflammatory rheumatic disease such as RA, lupus and spondyloarthritis [5]. We assessed whether SS was associated with higher complication, mortality and healthcare utilization rates after primary TKA or THA
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