Where Do We Stand Today on Racial and Ethnic Health Disparities? An Analysis of Primary Total Hip Arthroplasty From a 2011–2017 National Database
Background: Little is known about the persistence of health disparities in joint arthroplasty. The objective of this study was to update our knowledge on the state of racial and ethnic disparities in total hip arthroplasty (THA). Methods: Patients undergoing primary, elective THA using the 2011-2017...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-12-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344120302065 |
| _version_ | 1819006323786776576 |
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| author | Olohirere T. Ezomo, MPH Daniel Sun, MD Christian Gronbeck, BS Melvyn A. Harrington, MD Mohamad J. Halawi, MD |
| author_facet | Olohirere T. Ezomo, MPH Daniel Sun, MD Christian Gronbeck, BS Melvyn A. Harrington, MD Mohamad J. Halawi, MD |
| author_sort | Olohirere T. Ezomo, MPH |
| collection | DOAJ |
| description | Background: Little is known about the persistence of health disparities in joint arthroplasty. The objective of this study was to update our knowledge on the state of racial and ethnic disparities in total hip arthroplasty (THA). Methods: Patients undergoing primary, elective THA using the 2011-2017 American College of Surgeons National Surgical Quality Improvement Program were retrospectively reviewed. Five minority groups (non-Hispanic black or African American, Hispanic or Latino, Asian, American Indian or Alaska Native, and Native Hawaiian or Pacific Islander) were compared with non-Hispanic whites. The primary outcomes were in the differences in demographic characteristics, comorbidities, perioperative characteristics, THA utilization, length of stay (LOS), and 30-day adverse events (mortality, readmission, reoperation, and complications). Results: A total of 155,870 patients were identified with racial and ethnic data available on 134,961 (86.6%) of them. Non-Hispanic white patients comprised 74.5% of all THA procedures. Except for Asians, all minority groups were more likely to be younger, have a higher body mass index, and smoke tobacco (P < .001). There were higher rates of nonprimary osteoarthritis, procedure length exceeding 100 minutes, and comorbidities among all minority groups. All minority groups, except Asian and Hawaiians or Pacific Islanders, were more likely to require an LOS >2 days. Blacks were more likely to develop surgical or medical complications (odds ratio [OR]: 1.21 and 1.2, respectively), whereas Hispanics or Latinos were more likely to develop surgical complications (OR: 1.28). American Indians or Alaska Natives were more likely to undergo reoperations (OR: 1.91). Conclusions: Health disparities persist among minority groups with respect to comorbidities, THA utilization, LOS, and complications. Blacks and Hispanics or Latinos appear to be the most impacted by these disparities. |
| first_indexed | 2024-12-21T00:06:52Z |
| format | Article |
| id | doaj.art-ab0495e075094258b2d0a7ba5bfc02bd |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-12-21T00:06:52Z |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-ab0495e075094258b2d0a7ba5bfc02bd2022-12-21T19:22:27ZengElsevierArthroplasty Today2352-34412020-12-0164872876Where Do We Stand Today on Racial and Ethnic Health Disparities? An Analysis of Primary Total Hip Arthroplasty From a 2011–2017 National DatabaseOlohirere T. Ezomo, MPH0Daniel Sun, MD1Christian Gronbeck, BS2Melvyn A. Harrington, MD3Mohamad J. Halawi, MD4The Frank H. Netter M.D. School of Medicine at Quinnipiac University, North Haven, CT, USADepartment of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX, USAUniversity of Connecticut School of Medicine, Farmington, CT, USADepartment of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX, USADepartment of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX, USA; Corresponding author. Department of Orthopaedic Surgery, Baylor College of Medicine, 7200 Cambridge Street, Suite 10A, Houston, TX, 77030, USA. Tel.: +1 713 986 6016.Background: Little is known about the persistence of health disparities in joint arthroplasty. The objective of this study was to update our knowledge on the state of racial and ethnic disparities in total hip arthroplasty (THA). Methods: Patients undergoing primary, elective THA using the 2011-2017 American College of Surgeons National Surgical Quality Improvement Program were retrospectively reviewed. Five minority groups (non-Hispanic black or African American, Hispanic or Latino, Asian, American Indian or Alaska Native, and Native Hawaiian or Pacific Islander) were compared with non-Hispanic whites. The primary outcomes were in the differences in demographic characteristics, comorbidities, perioperative characteristics, THA utilization, length of stay (LOS), and 30-day adverse events (mortality, readmission, reoperation, and complications). Results: A total of 155,870 patients were identified with racial and ethnic data available on 134,961 (86.6%) of them. Non-Hispanic white patients comprised 74.5% of all THA procedures. Except for Asians, all minority groups were more likely to be younger, have a higher body mass index, and smoke tobacco (P < .001). There were higher rates of nonprimary osteoarthritis, procedure length exceeding 100 minutes, and comorbidities among all minority groups. All minority groups, except Asian and Hawaiians or Pacific Islanders, were more likely to require an LOS >2 days. Blacks were more likely to develop surgical or medical complications (odds ratio [OR]: 1.21 and 1.2, respectively), whereas Hispanics or Latinos were more likely to develop surgical complications (OR: 1.28). American Indians or Alaska Natives were more likely to undergo reoperations (OR: 1.91). Conclusions: Health disparities persist among minority groups with respect to comorbidities, THA utilization, LOS, and complications. Blacks and Hispanics or Latinos appear to be the most impacted by these disparities.http://www.sciencedirect.com/science/article/pii/S2352344120302065RaceEthnicityHealth disparitiesTotal hip arthroplasty30-Day adverse events |
| spellingShingle | Olohirere T. Ezomo, MPH Daniel Sun, MD Christian Gronbeck, BS Melvyn A. Harrington, MD Mohamad J. Halawi, MD Where Do We Stand Today on Racial and Ethnic Health Disparities? An Analysis of Primary Total Hip Arthroplasty From a 2011–2017 National Database Arthroplasty Today Race Ethnicity Health disparities Total hip arthroplasty 30-Day adverse events |
| title | Where Do We Stand Today on Racial and Ethnic Health Disparities? An Analysis of Primary Total Hip Arthroplasty From a 2011–2017 National Database |
| title_full | Where Do We Stand Today on Racial and Ethnic Health Disparities? An Analysis of Primary Total Hip Arthroplasty From a 2011–2017 National Database |
| title_fullStr | Where Do We Stand Today on Racial and Ethnic Health Disparities? An Analysis of Primary Total Hip Arthroplasty From a 2011–2017 National Database |
| title_full_unstemmed | Where Do We Stand Today on Racial and Ethnic Health Disparities? An Analysis of Primary Total Hip Arthroplasty From a 2011–2017 National Database |
| title_short | Where Do We Stand Today on Racial and Ethnic Health Disparities? An Analysis of Primary Total Hip Arthroplasty From a 2011–2017 National Database |
| title_sort | where do we stand today on racial and ethnic health disparities an analysis of primary total hip arthroplasty from a 2011 2017 national database |
| topic | Race Ethnicity Health disparities Total hip arthroplasty 30-Day adverse events |
| url | http://www.sciencedirect.com/science/article/pii/S2352344120302065 |
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