Outcome and cost analysis of primary total knee arthroplasty in end-stage renal disease patients: A nationwide population-based study

Background: A number of patients with end-stage renal disease (ESRD) undergo total knee arthroplasty (TKA) due to advanced knee joint osteoarthritis. There are few studies describing the incidence, morbidities, mortality rate, and cost analysis regarding ESRD patients receiving TKA. Methods: We retr...

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Autores principales:	Sheng-Hsun Lee, Yu-Chih Lin, Chee-Jen Chang, Chih-Yun Fan Chiang, Szu-Yuan Chen, Yu-Han Chang, Pang-Hsin Hsieh, Chih-Hsiang Chang
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	End-stage renal disease Total knee arthroplasty Outcome Medicine (General) R5-920 Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/d2248cd3f0b5410387e394d19c4874d0
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spelling	oai:doaj.org-article:d2248cd3f0b5410387e394d19c4874d02021-11-28T04:33:01ZOutcome and cost analysis of primary total knee arthroplasty in end-stage renal disease patients: A nationwide population-based study2319-417010.1016/j.bj.2020.04.010https://doaj.org/article/d2248cd3f0b5410387e394d19c4874d02021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2319417020300470https://doaj.org/toc/2319-4170Background: A number of patients with end-stage renal disease (ESRD) undergo total knee arthroplasty (TKA) due to advanced knee joint osteoarthritis. There are few studies describing the incidence, morbidities, mortality rate, and cost analysis regarding ESRD patients receiving TKA. Methods: We retrospectively retrieved patient data from National Health Insurance Research Database in Taiwan during 2005–2011, and evaluated the outcomes of TKA in patients with (ESRD group) and without ESRD (non-ESRD group). Patients’ demographic data, comorbidities, mortality, and in-hospital cost were recorded. Results: A total of 578 TKAs and 110,895 TKAs were identified in the ESRD and non-ESRD group, respectively. The incidence of patients receiving TKA was higher in the ESRD than in non-ESRD group by at least 2 folds. The ESRD group showed significantly more medical complications (pneumonia, peptic ulcer disease, and acute myocardial infarction) after surgery. In prosthesis-related complications, the ESRD group also had more periprosthetic joint infections, and prosthetic loosenings by one year. The one-year mortality rate was more than 6 times higher in the ESRD than in the non-ESRD group. The ESRD group had higher in-hospital medical expense than the non-ESRD group, especially when there were complications, even when the dialysis-related costs were exempted. Conclusion: The complication rate, mortality rate, and cost were higher in the ESRD patients receiving TKA. When considering TKA in ESRD patients, it is crucial to weigh the risks against benefits of TKA, and have a thorough discussion with the patients.Sheng-Hsun LeeYu-Chih LinChee-Jen ChangChih-Yun Fan ChiangSzu-Yuan ChenYu-Han ChangPang-Hsin HsiehChih-Hsiang ChangElsevierarticleEnd-stage renal diseaseTotal knee arthroplastyOutcomeMedicine (General)R5-920Biology (General)QH301-705.5ENBiomedical Journal, Vol 44, Iss 5, Pp 620-626 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	End-stage renal disease Total knee arthroplasty Outcome Medicine (General) R5-920 Biology (General) QH301-705.5
spellingShingle	End-stage renal disease Total knee arthroplasty Outcome Medicine (General) R5-920 Biology (General) QH301-705.5 Sheng-Hsun Lee Yu-Chih Lin Chee-Jen Chang Chih-Yun Fan Chiang Szu-Yuan Chen Yu-Han Chang Pang-Hsin Hsieh Chih-Hsiang Chang Outcome and cost analysis of primary total knee arthroplasty in end-stage renal disease patients: A nationwide population-based study
description	Background: A number of patients with end-stage renal disease (ESRD) undergo total knee arthroplasty (TKA) due to advanced knee joint osteoarthritis. There are few studies describing the incidence, morbidities, mortality rate, and cost analysis regarding ESRD patients receiving TKA. Methods: We retrospectively retrieved patient data from National Health Insurance Research Database in Taiwan during 2005–2011, and evaluated the outcomes of TKA in patients with (ESRD group) and without ESRD (non-ESRD group). Patients’ demographic data, comorbidities, mortality, and in-hospital cost were recorded. Results: A total of 578 TKAs and 110,895 TKAs were identified in the ESRD and non-ESRD group, respectively. The incidence of patients receiving TKA was higher in the ESRD than in non-ESRD group by at least 2 folds. The ESRD group showed significantly more medical complications (pneumonia, peptic ulcer disease, and acute myocardial infarction) after surgery. In prosthesis-related complications, the ESRD group also had more periprosthetic joint infections, and prosthetic loosenings by one year. The one-year mortality rate was more than 6 times higher in the ESRD than in the non-ESRD group. The ESRD group had higher in-hospital medical expense than the non-ESRD group, especially when there were complications, even when the dialysis-related costs were exempted. Conclusion: The complication rate, mortality rate, and cost were higher in the ESRD patients receiving TKA. When considering TKA in ESRD patients, it is crucial to weigh the risks against benefits of TKA, and have a thorough discussion with the patients.
format	article
author	Sheng-Hsun Lee Yu-Chih Lin Chee-Jen Chang Chih-Yun Fan Chiang Szu-Yuan Chen Yu-Han Chang Pang-Hsin Hsieh Chih-Hsiang Chang
author_facet	Sheng-Hsun Lee Yu-Chih Lin Chee-Jen Chang Chih-Yun Fan Chiang Szu-Yuan Chen Yu-Han Chang Pang-Hsin Hsieh Chih-Hsiang Chang
author_sort	Sheng-Hsun Lee
title	Outcome and cost analysis of primary total knee arthroplasty in end-stage renal disease patients: A nationwide population-based study
title_short	Outcome and cost analysis of primary total knee arthroplasty in end-stage renal disease patients: A nationwide population-based study
title_full	Outcome and cost analysis of primary total knee arthroplasty in end-stage renal disease patients: A nationwide population-based study
title_fullStr	Outcome and cost analysis of primary total knee arthroplasty in end-stage renal disease patients: A nationwide population-based study
title_full_unstemmed	Outcome and cost analysis of primary total knee arthroplasty in end-stage renal disease patients: A nationwide population-based study
title_sort	outcome and cost analysis of primary total knee arthroplasty in end-stage renal disease patients: a nationwide population-based study
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/d2248cd3f0b5410387e394d19c4874d0
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Outcome and cost analysis of primary total knee arthroplasty in end-stage renal disease patients: A nationwide population-based study

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