Readmission rate and healthcare utilization outcomes of computer-assisted fluoroscopy-based hip navigation versus manual total hip arthroplasty.

IF 2.9 3区医学 Q3 ENGINEERING, BIOMEDICAL Expert Review of Medical Devices Pub Date : 2023-07-01 Epub Date: 2023-07-25 DOI:10.1080/17434440.2023.2238609

William G Hamilton, Robert A Sershon, Anshu Gupta, Laura Goldstein, Mina Kabiri, Chantal E Holy, Rodrigo Diaz

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Abstract

Introduction: The study evaluates the technology of fluoroscopy-based hip navigation that has shown to improve implant positioning in total hip arthroplasty (THA).

Methods: Premier Healthcare data for patients undergoing manual THA or fluoroscopy-based hip navigation THA between 1 January 2016-30 September 2021, were analyzed 90- and 365-day post-THA. The primary outcome was inpatient readmission. Secondary outcomes were operating room (OR) time, length of stay, discharge status, and hospital costs. Baseline covariate differences were balanced using fine stratification and analyzed using generalized linear models.

Results: Among 4,080 fluoroscopy-based hip navigation THA and 429,533 manual THA balanced patients, hip-related readmission rates were statistically significantly lower for the fluoroscopy-based hip navigation THA cohort vs. manual THA for both 90-day (odd ratio [95% CI]: 0.69 [0.52 to 0.91] and 365-day (0.63 [0.49 to 0.81] follow-up. OR time was higher with fluoroscopy-based hip navigation THA vs. manual THA (134.65 vs. 132.04 minutes); however, fluoroscopy-based hip navigation THA patients were more likely to be discharged to home (93.73% vs. 90.11%) vs. manual THA. Hospital costs were not different between cohorts at 90- and 365-day post-operative.

Conclusions: Fluoroscopy-based hip navigation THA resulted in fewer readmissions, greater discharge to home, and similar hospital costs compared to manual THA.

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基于计算机辅助荧光透视的髋关节导航与人工全髋关节置换术的再移植率和医疗保健利用结果。

引言：该研究评估了基于荧光透视的髋关节导航技术，该技术已被证明可以改善全髋关节置换术（THA）中的植入物定位。方法：分析2021年1月1日至2021年9月30日期间接受手动THA或基于荧光透视髋关节导航THA的患者在THA后90天和365天的Premier Healthcare数据。主要结果是住院患者再次入院。次要结果是手术室（OR）时间、住院时间、出院状态和住院费用。基线协变量差异使用精细分层进行平衡，并使用广义线性模型进行分析。结果：4080例基于透视的髋关节导航THA和429533例手动THA平衡患者中，在90天（奇数比[95%CI]:0.69[0.52-0.91]）和365天（0.63[0.49-0.81]）的随访中，基于荧光透视的髋关节导航THA队列的髋关节相关再入院率在统计学上显著低于手动THA。基于荧光透视髋关节导航的THA的OR时间高于手动THA（134.65vs.132.04 分钟）；然而，与手动THA相比，基于荧光透视的髋关节导航THA患者更有可能出院回家（93.73%对90.11%）。术后90天和365天的住院费用在不同队列之间没有差异。结论：与手动THA相比，基于荧光镜的髋关节导航THA导致更少的再次入院、更多的出院回家以及相似的住院费用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Medical Devices 医学-工程：生物医学

CiteScore

5.90

自引率

3.20%

发文量

审稿时长

6-12 weeks

期刊介绍： The journal serves the device research community by providing a comprehensive body of high-quality information from leading experts, all subject to rigorous peer review. The Expert Review format is specially structured to optimize the value of the information to reader. Comprehensive coverage by each author in a key area of research or clinical practice is augmented by the following sections: Expert commentary - a personal view on the most effective or promising strategies Five-year view - a clear perspective of future prospects within a realistic timescale Key issues - an executive summary cutting to the author''s most critical points In addition to the Review program, each issue also features Medical Device Profiles - objective assessments of specific devices in development or clinical use to help inform clinical practice. There are also Perspectives - overviews highlighting areas of current debate and controversy, together with reports from the conference scene and invited Editorials.