Newman JM, et al. - Parkinson’s disease (PD) patients who underwent total hip arthroplasty (THA) were examined for perioperative outcomes, specifically for perioperative surgical and medical complications; lengths of stay (LOS); and total hospital charges. Involvement of orthopaedic surgeons and neurologists in the preoperative counseling of PD patients was recommended, with respect to their potential increased risks associated with THA, which could help optimize their preoperative care. Moreover, in this patient population, the risk of complications and higher costs could potentially lead to the development of different reimbursement methods.

Methods

• Researchers identified patients who had PD and underwent THA between 2002-2013, using the Nationwide Inpatient Sample.
• They used propensity scores to match PD patients in a 1:3 ratio to patients without PD by year of surgery, age, gender, race, Charlson/Deyo score, and insurance type.
• A total of 10,519 PD and 31,679 non-PD THA patients were included.
• They used regression analyses to compare the risk of perioperative complications (any, surgical, medical), the percent differences in mean LOS, and the percent differences in total hospital charges.

Results

• Findings demonstrated that PD patients vs the matched cohort had a 52% higher risk for any complication (OR=1.52; 95%CI, 1.37-1.69), a 30% higher risk for any surgical complication (OR=1.30; 95%CI: 0.88-1.91), and a 54% higher risk for any medical complication (OR=1.54; 95%CI, 1.38-1.71).
• Researchers observed that postoperative delirium (OR=2.61; 95%CI: 1.77-3.85), altered mental status (OR=3.01; 95%CI: 1.35-6.71), urinary tract infection (OR=1.34; 95%CI: 1.09-1.76), and blood transfusion (OR=1.62; 95%CI: 1.44-1.82) were more likely in PD patients.
• Also, data revealed that PD patients had a mean LOS that was 8.57% longer (p<0.0001), and mean total hospital charges that were 3.85% higher (p<0.0001).