Few Procedures Account for Most Ortho Adverse Events

Hip fracture repair, total knee arthroplasty lead list for adverse events linked to orthopedic surgery
By Eric Metcalf
HealthDay Reporter

MONDAY, Aug. 9 (HealthDay News) -- Most adverse events that occur within 30 days after orthopedic surgery arise from a small number of procedures, according to research published in the Aug. 4 issue of the Journal of Bone & Joint Surgery.

Peter L. Schilling, M.D., of the University of Michigan in Ann Arbor, and colleagues analyzed data from the American College of Surgeons National Surgical Quality Improvement Program on 7,970 patients who underwent orthopedic surgery between 2005 and 2007. The researchers categorized patients in 44 procedure groups based on Current Procedural Terminology codes, and focused on adverse events in the first 30 postoperative days and excess length of hospital stay.

The researchers found that 10 procedures accounted for 65 percent of excess hospital days and 70 percent of adverse events. Hip fracture repair made up the largest share of adverse events, at 19 percent, followed by total knee arthroplasty (18 percent) and total hip arthroplasty (11 percent). The other procedure groups that accounted for more than 2 percent of adverse events were revision total hip arthroplasty, knee arthroscopy, and laminectomy.

"Although the rank lists in our study are imperfect, our intention is for surgeons and other stakeholders to use them as a guide to direct future safety and quality-improvement efforts in orthopedic surgery. With growing pressure to measure and improve quality in orthopedic surgery, there is no doubt that there is much work to be done, and orthopedic surgery is only just out of the starting blocks," the authors write.

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