In the Journals

Simultaneous and staged bilateral TJA yielded similar episode-of-care costs

Results published in The Journal of Arthroplasty showed no differences in the 90-day episode-of-care costs among Medicare patients who underwent either simultaneous or staged bilateral total joint arthroplasty.

Researchers recorded demographics, comorbidities, readmission rates and 90-day episode-of-care costs based on CMS claims data among 319 patients undergoing simultaneous primary TJA and 168 patients undergoing staged TJA. To identify independent risk factors for increased costs, researchers performed a multivariate regression analysis.

Although results showed no differences between staged and simultaneous bilateral TJA in overall 90-day episode-of-care costs, researchers noted patients in the staged bilateral TJA group had higher mean combined inpatient facility cost and patients in the simultaneous bilateral TJA group had higher mean total post-acute care costs. Patients in the staged bilateral TJA group had a shorter average length of stay per episode and a greater proportion were discharged home. Both groups had similar readmission and complication rates, according to results, but patients in the simultaneous group had a greater rate of venous thromboembolic events. Researchers found inpatient rehabilitation was required in most patients in the simultaneous bilateral group.

Results showed simultaneous surgery was not associated with an increase in episode-of-care costs when controlling for demographics, procedure and comorbidities. Researchers noted age, cardiac disease, history of stroke and liver disease were independent risk factors for increased episode-of-care costs following bilateral TJA. – by Casey Tingle

Disclosures: Phillips reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.

Results published in The Journal of Arthroplasty showed no differences in the 90-day episode-of-care costs among Medicare patients who underwent either simultaneous or staged bilateral total joint arthroplasty.

Researchers recorded demographics, comorbidities, readmission rates and 90-day episode-of-care costs based on CMS claims data among 319 patients undergoing simultaneous primary TJA and 168 patients undergoing staged TJA. To identify independent risk factors for increased costs, researchers performed a multivariate regression analysis.

Although results showed no differences between staged and simultaneous bilateral TJA in overall 90-day episode-of-care costs, researchers noted patients in the staged bilateral TJA group had higher mean combined inpatient facility cost and patients in the simultaneous bilateral TJA group had higher mean total post-acute care costs. Patients in the staged bilateral TJA group had a shorter average length of stay per episode and a greater proportion were discharged home. Both groups had similar readmission and complication rates, according to results, but patients in the simultaneous group had a greater rate of venous thromboembolic events. Researchers found inpatient rehabilitation was required in most patients in the simultaneous bilateral group.

Results showed simultaneous surgery was not associated with an increase in episode-of-care costs when controlling for demographics, procedure and comorbidities. Researchers noted age, cardiac disease, history of stroke and liver disease were independent risk factors for increased episode-of-care costs following bilateral TJA. – by Casey Tingle

Disclosures: Phillips reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.