Abstract
BackgroundHip arthroplasties is one of the most frequent surgical procedures in Spain and are conducted mainly in elderly subjects. We aim to analyze changes in incidence, co-morbidity profile, length of hospital stay (LOHS), costs and in-hospital mortality (IHM) of patients undergoing primary total hip arthroplasty (THA) over an 8-year study period in Spain.MethodsWe selected all surgical admissions in individuals aged ≥40 years who had received a primary THA (ICD-9-CM procedure code 81.51) between 2001 and 2008 from the National Hospital Discharge Database. Age- and sex-specific incidence rates, LOHS, costs and IHM were estimated for each year. Co-morbidity was assessed using the Charlson comorbidity index.Multivariate analysis of time trends was conducted using Poisson regression. Logistic regression models were conducted to analyze IHM.ResultsWe identified a total of 161,791 discharges of patients having undergone THA from 2001 to 2008. Overall crude incidence had increased from 99 to 105 THA per 100.000 inhabitants from 2001 to 2008 (p < 0.001). In 2001, 81% of patients had a Charlson Index of 0, 18.4% of 1-2, and 0.6% > 2 and in 2008, the prevalence of 1-2 or >2 had increased to 20.4% and 1.1% respectively (p < 0.001). The mean LOHS was 13 days in 2001 and decreased to 10.45 days in 2008 (p < 0.001). During the period studied, the mean cost per patient increased from 6,634 to 9,474 Euros. Multivariate analysis shows that from 2001 to 2008 the incidence of THA hospitalizations has significantly increased for both sexes and only men showed a significant reduction in IHM after THA.ConclusionsThe current study provides clear and valid data indicating increased incidence of primary THA in Spain from 2001 to 2008 with concomitant reductions in LOHS, slight reduction IHM, but a significant increase in cost per patient. The health profile of the patient undergoing a THA seems to be worsening in Spain.
Highlights
Hip arthroplasties is one of the most frequent surgical procedures in Spain and are conducted mainly in elderly subjects
According to the Spanish Health System Organization, each physician must declare, at the time of discharge of each hospitalization all diagnoses and procedures performed, using the code of the International Classification of Disease, 9th revision (ICD-9CM). This information is collected by the Spanish National Hospital Database, namely Conjunto Minimo Basico de Datos (CMBD) that compiles all the public and private hospital data covering more than 95% of hospital discharges [16]
The proportion of patients that died during the hospital admission, length of hospital stay (LOHS), and costs were estimated for each year studied
Summary
Hip arthroplasties is one of the most frequent surgical procedures in Spain and are conducted mainly in elderly subjects. We aim to analyze changes in incidence, co-morbidity profile, length of hospital stay (LOHS), costs and in-hospital mortality (IHM) of patients undergoing primary total hip arthroplasty (THA) over an 8-year study period in Spain. Collecting data about hospitalizations for THA is important at a country level to evaluate the incidence, patient characteristics and outcome of the surgery in variables such as length of stay (LOHS), complications, mortality and burden of disease [7]. Current projections for the United States suggest that from 2005 to 2030 the number of THA will increase by 174%, to nearly 600,000 procedures per year [11]. The economic burden of THA surgery is high, constantly increasing and shows great variation between countries [12,13]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
