scholarly journals Delay in Diagnosis of Invasive Surgical Site Infections Following Knee Arthroplasty Versus Hip Arthroplasty

2014 ◽  
Vol 60 (7) ◽  
pp. 990-996 ◽  
Author(s):  
Sarah S. Lewis ◽  
Kristen V. Dicks ◽  
Luke F. Chen ◽  
Michael P. Bolognesi ◽  
Deverick J. Anderson ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Surgical Site Infections ◽  
Delay In Diagnosis

scholarly journals Use of Medicare Diagnosis and Procedure Codes to Improve Detection of Surgical Site Infections following Hip Arthroplasty, Knee Arthroplasty, and Vascular Surgery

2012 ◽  
Vol 33 (1) ◽  
pp. 40-49 ◽  
Author(s):  
Michael S. Calderwood ◽  
Allen Ma ◽  
Yosef M. Khan ◽  
Margaret A. Olsen ◽  
Dale W. Bratzler ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Surgical Site Infections ◽  
Fold Increase ◽  
International Classification Of Diseases ◽  
Medicare Claims ◽  
Classification Of Diseases ◽  
Control And Prevention ◽  
Procedure Codes

Objective.To evaluate the use of routinely collected electronic health data in Medicare claims to identify surgical site infections (SSIs) following hip arthroplasty, knee arthroplasty, and vascular surgery.Design.Retrospective cohort study.Setting.Four academic hospitals that perform prospective SSI surveillance.Methods.We developed lists of International Classification of Diseases, Ninth Revision, and Current Procedural Terminology diagnosis and procedure codes to identify potential SSIs. We then screened for these codes in Medicare claims submitted by each hospital on patients older than 65 years of age who had undergone 1 of the study procedures during 2007. Each site reviewed medical records of patients identified by either claims codes or traditional infection control surveillance to confirm SSI using Centers for Disease Control and Prevention/ National Healthcare Safety Network criteria. We assessed the performance of both methods against all chart-confirmed SSIs identified by either method.Results.Claims-based surveillance detected 1.8–4.7-fold more SSIs than traditional surveillance, including detection of all previously identified cases. For hip and vascular surgery, there was a 5-fold and 1.6-fold increase in detection of deep and organ/space infections, respectively, with no increased detection of deep and organ/space infections following knee surgery. Use of claims to trigger chart review led to confirmation of SSI in 1 out of 3 charts for hip arthroplasty, 1 out of 5 charts for knee arthroplasty, and 1 out of 2 charts for vascular surgery.Conclusion.Claims-based SSI surveillance markedly increased the number of SSIs detected following hip arthroplasty, knee arthroplasty, and vascular surgery. It deserves consideration as a more effective approach to target chart reviews for identifying SSIs.Infect Control Hosp Epidemiol 2012;33(1):40-49

scholarly journals Effectiveness of a multistate quality improvement campaign in reducing risk of surgical site infections following hip and knee arthroplasty

2018 ◽  
Vol 28 (5) ◽  
pp. 374-381 ◽  
Author(s):  
Michael S Calderwood ◽  
Deborah S Yokoe ◽  
Michael V Murphy ◽  
Katherine O DeBartolo ◽  
Kathy Duncan ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Surgical Site Infections ◽  
Evidence Based ◽  
Medicare Beneficiaries ◽  
Evidence Based Practices ◽  
Lower Odds ◽  
Hip And Knee Arthroplasty ◽  
Matched Comparison

BackgroundQuality improvement (QI) campaigns appear to increase use of evidence-based practices, but their effect on health outcomes is less well studied.ObjectiveTo assess the effect of a multistate QI campaign (Project JOINTS, Joining Organizations IN Tackling SSIs) that used the Institute for Healthcare Improvement’s Rapid Spread Network to promote adoption of evidence-based surgical site infection (SSI) prevention practices.MethodsWe analysed rates of SSI among Medicare beneficiaries undergoing hip and knee arthroplasty during preintervention (May 2010 to April 2011) and postintervention (November 2011 to September 2013) periods in five states included in a multistate trial of the Project JOINTS campaign and five matched comparison states. We used generalised linear mixed effects models and a difference-in-differences approach to estimate changes in SSI outcomes.Results125 070 patients underwent hip arthroplasty in 405 hospitals in intervention states, compared with 131 787 in 525 hospitals in comparison states. 170 663 patients underwent knee arthroplasty in 397 hospitals in intervention states, compared with 196 064 in 518 hospitals in comparison states. After the campaign, patients in intervention states had a 15% lower odds of developing hip arthroplasty SSIs (OR=0.85, 95% CI 0.75 to 0.96, p=0.01) and a 12% lower odds of knee arthroplasty SSIs than patients in comparison states (OR=0.88, 95% CI 0.78 to 0.99, p=0.04).ConclusionsA larger reduction of SSI rates following hip and knee arthroplasty was shown in intervention states than in matched control states.

A Comparative Analysis of Patient Satisfaction following Total Knee Arthroplasty and Total Hip Arthroplasty Using the Forgotten Joint Score

2020 ◽  
Vol 04 (02) ◽  
pp. 084-089
Author(s):  
Vivek Singh ◽  
Stephen Zak ◽  
Ran Schwarzkopf ◽  
Roy Davidovitch
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Demographic Data ◽  
Demographic Differences ◽  
Total Hip ◽  
Forgotten Joint Score ◽  
Total Knee

AbstractMeasuring patient satisfaction and surgical outcomes following total joint arthroplasty remains controversial with most tools failing to account for both surgeon and patient satisfaction in regard to outcomes. The purpose of this study was to use “The Forgotten Joint Score” questionnaire to assess clinical outcomes comparing patients who underwent a total hip arthroplasty (THA) with those who underwent a total knee arthroplasty (TKA). We conducted a retrospective review of patients who underwent primary THA or TKA between September 2016 and September 2019 and responded to the Forgotten Joint Score-12 (FJS-12) questionnaire at least at one of three time periods (3, 12, and 21 months), postoperatively. An electronic patient rehabilitation application was used to administer the questionnaire. Collected variables included demographic data (age, gender, race, body mass index [BMI], and smoking status), length of stay (LOS), and FJS-12 scores. t-test and chi-square were used to determine significance. Linear regression was used to account for demographic differences. A p-value of less than 0.05 was considered statistically significant. Of the 2,359 patients included in this study, 1,469 underwent a THA and 890 underwent a TKA. Demographic differences were observed between the two groups with the TKA group being older, with higher BMI, higher American Society of Anesthesiologists scores, and longer LOS. Accounting for the differences in demographic data, THA patients consistently had higher scores at 3 months (53.72 vs. 24.96; p < 0.001), 12 months (66.00 vs. 43.57; p < 0.001), and 21 months (73.45 vs. 47.22; p < 0.001). FJS-12 scores for patients that underwent THA were significantly higher in comparison to TKA patients at 3, 12, and 21 months postoperatively. Increasing patient age led to a marginal increase in FJS-12 score in both cohorts. With higher FJS-12 scores, patients who underwent THA may experience a more positive evolution with their surgery postoperatively than those who had TKA.

scholarly journals Validation of an algorithm for semiautomated surveillance to detect deep surgical site infections after primary total hip or knee arthroplasty—A multicenter study

2020 ◽  
Vol 42 (1) ◽  
pp. 69-74
Author(s):  
Janneke D. M. Verberk ◽  
Stephanie M. van Rooden ◽  
Mayke B. G. Koek ◽  
David J. Hetem ◽  
Annelies E. Smilde ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
High Probability ◽  
Surgical Site Infections ◽  
Data Interpretation ◽  
Routine Care ◽  
Successful Implementation ◽  
Subjective Data ◽  
Essential Information ◽  
Total Hip ◽  
Healthcare Associated

AbstractObjective:Surveillance of healthcare-associated infections is often performed by manual chart review. Semiautomated surveillance may substantially reduce workload and subjective data interpretation. We assessed the validity of a previously published algorithm for semiautomated surveillance of deep surgical site infections (SSIs) after total hip arthroplasty (THA) or total knee arthroplasty (TKA) in Dutch hospitals. In addition, we explored the ability of a hospital to automatically select the patients under surveillance.Design:Multicenter retrospective cohort study.Methods:Hospitals identified patients who underwent THA or TKA either by procedure codes or by conventional surveillance. For these patients, routine care data regarding microbiology results, antibiotics, (re)admissions, and surgeries within 120 days following THA or TKA were extracted from electronic health records. Patient selection was compared with conventional surveillance and patients were retrospectively classified as low or high probability of having developed deep SSI by the algorithm. Sensitivity, positive predictive value (PPV), and workload reduction were calculated and compared to conventional surveillance.Results:Of 9,554 extracted THA and TKA surgeries, 1,175 (12.3%) were revisions, and 8,378 primary surgeries remained for algorithm validation (95 deep SSIs, 1.1%). Sensitivity ranged from 93.6% to 100% and PPV ranged from 55.8% to 72.2%. Workload was reduced by ≥98%. Also, 2 SSIs (2.1%) missed by the algorithm were explained by flaws in data selection.Conclusions:This algorithm reliably detects patients with a high probability of having developed deep SSI after THA or TKA in Dutch hospitals. Our results provide essential information for successful implementation of semiautomated surveillance for deep SSIs after THA or TKA.

scholarly journals Epidemiological And Economic Burden Of Surgical Site Infections (SSIS) Associated With Hip Arthroplasty

2014 ◽  
Vol 17 (3) ◽  
pp. A277
Author(s):  
H. Patel ◽  
H. Khoury ◽  
D. Girgenti ◽  
S. Welner ◽  
H. Yu
Keyword(s):  
Hip Arthroplasty ◽  
Economic Burden ◽  
Surgical Site Infections
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