Costs analysis of Staged Versus Simultaneous Bilateral Total Knee and Hip Arthroplasty: a university affiliated hospital survey of 1579 Chinese patients

Abstract Background: Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are required for many patients. No recent studies that concentrate on the costs for each of the payment items both for TKA and THA when comparing simultaneous bilateral procedures with staged arthroplasty. This study aimed to evaluate the medical costs, length of stay(LOS), blood transfusion, and in-hospital complications in patients undergoing simultaneous TKA or THA and staged TKA or THA. Methods: A retrospective cohort study was conducted by analyzing 1,579 patients from a single institution. All patients who underwent primary bilateral TKA or THA from 2013 to 2018 were divided into three groups: TKA,THA and all patients. Then, we grouping simultaneous bilateral groups and staged bilateral groups in these three groups respectively. Finally, these two sub-groups(simultaneous bilateral groups and staged bilateral groups) were compared between the three groups(TKA, THA, and pooled groups). Results: All categories of medical costs, except for materials fees which were higher in the simultaneous bilateral THA and pooled groups but with no statistical significance, were lower in the simultaneous TKA, THA and pooled simultaneous groups. The total average medical costs in simultaneous and staged bilateral TKA groups were $15,535.621and $16,747.192, p <0.001), respectively; THA groups were $15,046.210 and $16,126.808, ( p =0.003), respectively; pooled groups were $16,506.971and $15,467.561, ( p <0.001), respectively. All costs were presented in the United States dollar. The highest and lowest costs were materials fees and nursing care fees. No significant differences were found for five common co- morbidities and postoperative complications between the two sub-groups in three groups. The simultaneous groups had a shorter LOS, a higher incidence of blood transfusion than staged groups whether it is TKA groups or THA or pooled groups. Conclusions: These results indicate that simultaneous bilateral TKA and THA with a shorter LOS is more economical than staged bilateral TKA and THA. Counts of complications were not affected by the choice for staged or simultaneous bilateral total arthroplasty. But blood transfusion was more prevalent in the simultaneous groups both for TKA and THA.

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Costs analysis of Staged Versus Simultaneous Bilateral Total Knee and Hip Arthroplasty: a university affiliated hospital survey of 1579 Chinese patients

10.21203/rs.3.rs-18782/v1 ◽

2020 ◽

Author(s):

Ji-Fei Hou ◽

Chuan hu ◽

Yun Zhang ◽

Yan-Zheng Liu ◽

Chi Zhang ◽

...

Keyword(s):

Blood Transfusion ◽

Hip Arthroplasty ◽

Statistical Significance ◽

Medical Costs ◽

The United States ◽

Chinese Patients ◽

United States Dollar ◽

Total Arthroplasty ◽

Total Knee ◽

Knee And Hip Arthroplasty

Abstract Background Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are required for many patients. No recent studies that concentrate on the costs for each of the payment items both for TKA and THA when comparing simultaneous bilateral procedures with staged arthroplasty. This study aimed to evaluate the medical costs, length of stay(LOS), blood transfusion, and in-hospital complications in patients undergoing simultaneous TKA or THA and staged TKA or THA. Methods A retrospective cohort study was conducted by analyzing 1,579 patients from a single institution. All patients who underwent primary bilateral TKA or THA from 2013 to 2018 were divided into three groups: TKA,THA and all patients. Then, we grouping simultaneous bilateral groups and staged bilateral groups in these three groups respectively. Finally, these two sub-groups(simultaneous bilateral groups and staged bilateral groups) were compared between the three groups(TKA, THA, and pooled groups). Results All categories of medical costs, except for materials fees which were higher in the simultaneous bilateral THA and pooled groups but with no statistical significance, were lower in the simultaneous TKA, THA and pooled simultaneous groups. The total average medical costs in simultaneous and staged bilateral TKA groups were $15,535.621and $16,747.192, p <0.001), respectively; THA groups were $15,046.210 and $16,126.808, ( p =0.003), respectively; pooled groups were $16,506.971and $15,467.561, ( p <0.001), respectively. All costs were presented in the United States dollar. The highest and lowest costs were materials fees and nursing care fees. No significant differences were found for five common co-morbidities and postoperative complications between the two sub-groups in three groups. The simultaneous groups had a shorter LOS, a higher incidence of blood transfusion than staged groups whether it is TKA groups or THA or pooled groups. Conclusions These results indicate that simultaneous bilateral TKA and THA with a shorter LOS is more economical than staged bilateral TKA and THA. Counts of complications were not affected by the choice for staged or simultaneous bilateral total arthroplasty. But blood transfusion was more prevalent in the simultaneous groups both for TKA and THA.

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Costs analysis of Staged Versus Simultaneous Bilateral Total Knee and Hip Arthroplasty：a university affiliated hospital survey of 1579 Chinese patients

10.21203/rs.2.12776/v1 ◽

2019 ◽

Author(s):

Ji-Fei Hou ◽

Chuan Hu ◽

Yan-Zheng Liu ◽

Chi Zhang ◽

Jing Li ◽

...

Keyword(s):

Blood Transfusion ◽

Statistical Significance ◽

Cost Effective ◽

Medical Costs ◽

Chinese Patients ◽

Single Institution ◽

Total Arthroplasty ◽

Total Knee ◽

Simultaneous Bilateral Tka ◽

Total Average

Abstract Background Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are required for many patients. No recent studies that concentrate on the costs for each of the payment items both for TKA and THA when comparing simultaneous bilateral procedures with staged arthroplasty. This study aimed to evaluate the medical costs, length of stay(LOS), blood transfusion, and in-hospital complications in patients undergoing simultaneous TKA or THA and staged TKA or THA. Methods A retrospective cohort study was conducted by analyzing 1,579 patients from a single institution. All patients who underwent primary bilateral TKA or THA from 2013 to 2018 were divided into simultaneous bilateral and staged bilateral groups. These two sub-groups were compared between three groups(TKA, THA, and pooled groups). Results All categories of medical costs, except for materials fees which were higher in the simultaneous bilateral THA and pooled groups but with no statistical significance, were lower in the simultaneous TKA, THA and pooled simultaneous groups. The total average medical costs in simultaneous and staged bilateral TKA groups were $15,535.621($12,362.542,$16,450.131)and $16,747.192($14,670.273, $18,036.289), (p <0.001), respectively; THA groups were $15,046.210 ($12,838.230, $17,026.529) and $16,126.808 ($14,575.031, $18,867.963), (p=0.003), respectively; pooled groups were $16,506.971 ($14,618.267, $18,185.414) and $15,467.561 ($12,432.783, $16,494.155), (p <0.001), respectively. The highest and lowest costs were materials fees and nursing care fees. No significant differences were found for complications between the two sub-groups in three groups. The simultaneous groups had a shorter LOS, a higher incidence of blood transfusion than staged groups whether it is TKA groups or THA or pooled groups. Conclusions These results indicate that simultaneous bilateral TKA and THA with a shorter LOS is more cost-effective than staged bilateral TKA and THA. Counts of complications were not affected by the choice for staged or simultaneous bilateral total arthroplasty. But blood transfusion was more prevalent in the simultaneous groups both for TKA and THA.

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Cost analysis of staged versus simultaneous bilateral total knee and hip arthroplasty using a propensity score matching

BMJ Open ◽

10.1136/bmjopen-2020-041147 ◽

2021 ◽

Vol 11 (3) ◽

pp. e041147

Author(s):

Ji-Fei Hou ◽

Chuan Hu ◽

Yun Zhang ◽

Li-Qi Tian ◽

Yan-Zheng Liu ◽

...

Keyword(s):

Blood Transfusion ◽

Propensity Score ◽

Propensity Score Matching ◽

Nursing Care ◽

Hip Arthroplasty ◽

Medical Costs ◽

Complication Rates ◽

Propensity Score Matching Analysis ◽

Total Knee ◽

The Difference

BackgroundTotal joint arthroplasty (TJA), including total knee arthroplasty (TKA) and total hip arthroplasty (THA), is required for many patients. This study aimed to evaluate the medical costs, length of stay (LOS), blood transfusion and in-hospital complications in patients undergoing simultaneous and staged TJA.MethodsAll patients who underwent primary bilateral TJA from 2013 to 2018 in our institute were included. The propensity score matching analysis was performed between simultaneous and staged TJA patients. The difference in medical costs, LOS, blood transfusion and in-hospital complications was compared between simultaneous and staged groups.ResultsExcept for materials fees and general therapy fees, medical costs (bed fees, general therapy fees, nursing care fees, check-up and laboratory test fees, surgical fees and drug fees) were significantly lower in the simultaneous TKA, THA and TJA group. The total average medical costs in simultaneous and staged TKA groups were $15 385 and $16 729 (p<0.001), respectively; THA groups were $14 503 and $16 142 (p=0.016), respectively; TJA groups were $15 389 and $16 830 (p<0.001), respectively. The highest and lowest costs were materials fees and nursing care fees. No significant differences were found for five common comorbidities and postoperative complications between the two subgroups. The simultaneous groups had a shorter LOS and the differences from the staged group for TKA, THA and the TJA group were 8, 6 and 8 days, respectively. The incidence of blood transfusion is higher for simultaneous groups and the difference from the staged group for TKA, THA and TJA is 32.69%, 18% and 29.3%, respectively.ConclusionsOur results indicate that simultaneous TKA and THA with a shorter LOS would cost fewer (costs incurred during hospitalisation) than staged TKA and THA. Complication rates were not affected by the choice for staged or simultaneous arthroplasty, but the incidence of blood transfusion was higher in the simultaneous groups.

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Perioperative allogenic blood transfusion increases the incidence of postoperative deep vein thrombosis in total knee and hip arthroplasty

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1270-2 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 7

Author(s):

Tao Jiang ◽

Kai Song ◽

Yao Yao ◽

Pin Pan ◽

Qing Jiang

Keyword(s):

Deep Vein Thrombosis ◽

Blood Transfusion ◽

Hip Arthroplasty ◽

Allogenic Blood Transfusion ◽

Allogenic Blood ◽

Vein Thrombosis ◽

Postoperative Deep Vein Thrombosis ◽

Total Knee ◽

Knee And Hip Arthroplasty ◽

Deep Vein

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Perioperative Allogenic Blood Transfusion Increases the Incidence of Postoperative Deep Vein Thrombosis in Total Knee and Hip Arthroplasty

Journal of Vascular Surgery Venous and Lymphatic Disorders ◽

10.1016/j.jvsv.2019.10.003 ◽

2020 ◽

Vol 8 (1) ◽

pp. 165

Author(s):

T. Jiang ◽

K. Song ◽

Y. Yao ◽

P. Pan ◽

Q. Jiang

Keyword(s):

Deep Vein Thrombosis ◽

Blood Transfusion ◽

Hip Arthroplasty ◽

Allogenic Blood Transfusion ◽

Allogenic Blood ◽

Vein Thrombosis ◽

Postoperative Deep Vein Thrombosis ◽

Total Knee ◽

Knee And Hip Arthroplasty ◽

Deep Vein

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The incidence and risk factors for allogenic blood transfusion in total knee and hip arthroplasty

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1329-0 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 5

Author(s):

Kai Song ◽

Pin Pan ◽

Yao Yao ◽

Tao Jiang ◽

Qing Jiang

Keyword(s):

Risk Factors ◽

Blood Transfusion ◽

Hip Arthroplasty ◽

Allogenic Blood Transfusion ◽

Allogenic Blood ◽

Total Knee ◽

Knee And Hip Arthroplasty

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Blood Salvage in Total Hip and Knee Arthroplasty in a Community Hospital: A Retrospective Study

Journal of Orthopaedic Surgery ◽

10.1177/230949900501300104 ◽

2005 ◽

Vol 13 (1) ◽

pp. 19-26 ◽

Cited By ~ 9

Author(s):

R Jain ◽

S Jain

Keyword(s):

Total Knee Arthroplasty ◽

Blood Transfusion ◽

Knee Arthroplasty ◽

Hip Arthroplasty ◽

Allogeneic Blood Transfusion ◽

Allogeneic Blood ◽

Blood Salvage ◽

Total Hip ◽

Total Knee ◽

Knee And Hip Arthroplasty

Purposes: To assess the results of postoperative and intra-operative blood salvage in patients undergoing total knee and hip arthroplasty, respectively, and to determine if both methods of blood salvage reduce allogeneic transfusion. Methods: Of 229 patients who attempted blood salvage, 114 of 152 patients who underwent total knee arthroplasty received the salvaged blood postoperatively, 35 of 77 patients who underwent total hip arthroplasty received the salvaged blood intra-operatively. Various data were collected to assess whether certain factors resulted in autologous and/or allogeneic blood transfusions. Results: Patients that received postoperative salvaged blood after total knee arthroplasty generally had higher postoperative levels of haemoglobin and haematocrit compared to those who did not. Patients with autologous blood transfusion following cemented knee surgery were less likely to require allogeneic blood transfusion. For hip arthroplasty patients, postoperative levels of haemoglobin and haematocrit were similar in both groups who received and did not receive salvaged blood. Lower preoperative haemoglobin and haematocrit levels correlated with a greater likelihood of autologous and/or allogeneic blood transfusion for both knee and hip arthroplasty patients. Conclusions: Although total knee arthroplasty patients who received salvaged blood had higher haemoglobin levels on the first postoperative day, the receipt of salvaged blood did not significantly reduce the incidence of allogeneic blood transfusion, because salvaged blood was a kind of blood loss. However, reinfusion of salvaged blood may reduce the number of units of allogeneic blood used. Given the short supply of allogeneic blood and its risks of transmitting disease, intra-operative and postoperative blood salvage carries clear advantages.

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