Higher comorbidity, poor functional status and higher health care utilization in veterans with prevalent total knee arthroplasty or total hip arthroplasty
Singh JA et al. - Study reports poorer function and higher comorbidity and utilization in veterans with total knee arthroplasty/total hip arthroplasty (TKA/THA), suggesting that this group is appropriate for interventions targeted at improving function and decreasing utilization. Methods- Comparison of comorbidity, functional ability, and health care utilization in veterans with TKA or THA vs matched control populations
- A cohort of veterans reported limitations in 6 activities of daily living, demographics, and physician-diagnosed comorbidity
- Patients were classified as:
- Primary total knee arthroplasty (TKA)
- Primary total hip arthroplasty (THA)
- Combination group (≥1 procedure); and
- Control veteran population (no THA/TKA)
- Multivariable regression analyses compared the risk or counts of ADL limitation and in-/out-patient visits
Results- TKA, THA or combination groups had higher prevalence of the following, compared to veteran controls:
- arthritis, diabetes, or heart disease
- severe (≥3) ADL limitation (33%, 42%, 42% vs 24%) and
- annual hospitalization rate (24%, 19%, 26% vs 16%)
- Annual outpatient surgery visits were more and risk of any mental health outpatient visit was lower
- All ADLs, except eating, were more limited in arthroplasty groups
- Severe ADL limitation was more prevalent in veterans with arthroplasty than in two age-matched US cohorts:
- 13.4 times in ≥65 years and
- 1.2-, 1.6-, and 4-fold in ≥85, 75-84, and 65-74 years respectively
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