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Joint replacement surgery riskier at hospitals with low surgical volume
Date:6/6/2011

s 69 years, and men comprised 43% of the total hip replacement cohort and 35% of the total knee replacement group. Hospital volume was categorized by less than 25 surgeries, 26-100, 101-200 (low-volume hospitals), and greater than 200 surgeries (high-volume hospitals) performed annually.

The findings show that patients who had primary total hip arthroplasty at low-volume hospitals were more likely to develop a pulmonary embolism (within 30 days of surgery) than those who had surgery at a high-volume hospital. One-year mortality was also higher for patients having total hip replacements at low-volume hospitals.

Researchers found that for total knee arthroplasty, patients age 65 and older had significantly higher odds for one-year mortality when surgeries were performed at low-volume hospitals compared to higher volume hospitals.

The authors theorize that the causes of complications at low-volume hospitals could be connected to hospital procedures and peri- and post-operative care processes. One example cited is differences in the selection of the best medication and device used to prevent blood clots following elective joint replacement surgery. The authors also suggest that the outcome of surgery is impacted by time of initiation and cessation of the clot prevention therapy. Dr. Singh concluded, "Further studies are needed to investigate whether the underlying reasons for poor surgical outcomes at low-volume hospitals are modifiable and which interventions may reduce complications for patients at these facilities."


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Contact: Dawn Peters
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