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40
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Text
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<a href="http://doi.org/10.1007/s00402-019-03156-0" target="_blank" rel="noreferrer noopener">http://doi.org/10.1007/s00402-019-03156-0</a>
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NEOMED College
NEOMED College of Medicine
NEOMED Department
NEOMED Student Publications
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Title
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Occurrence of never events after total joint arthroplasty in the United States.
Publisher
An entity responsible for making the resource available
Archives of orthopaedic and trauma surgery
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-03
Subject
The topic of the resource
Total knee arthroplasty; Hospital-acquired condition; Medical quality; National Inpatient Sample; Never events; Total hip arthroplasty; Total joint arthroplasty
Creator
An entity primarily responsible for making the resource
Tsai Allen J
Description
An account of the resource
BACKGROUND: Total joint arthroplasty (TJA) is a major orthopedic procedure associated with substantial morbidity and mortality. Never events (NEs) are harmful hospital-acquired conditions (HACs) that are preventable. METHODS: Information on hospital admissions with TJA was collected from the National Inpatient Sample (NIS) from 2003 to 2012. NIS was queried to identify NE applicable to TJA patients based on the HAC definition listed by the Centers for Medicare and Medicaid Services (CMS). NEs were further compared before and after 2008 to evaluate the effect of the new CMS non-reimbursement policy on their incidence. RESULTS: A total of 8,176,774 patients were admitted with TJA from 2003 to 2012. 108,668 patients of these (1.33%) had >/= 1 NE. The most prevalent NE was fall and trauma (0.7%). Significant multivariable predictors with higher odds of developing at least one NE included weekend admission [odds ratio (99.9% CI), 4.3 (3.1, 5.8), p < 0.001] and weight loss [odds ratio (99.9% CI), 2.8 (2.2, 3.5), p < 0.001]. A temporal comparison of NE before and after 2008 revealed a decrease in total NE occurrence after 2008 when the CMS announced discontinuing payment for NE (1.39% vs. 1.25%, p < 0.001). After adjustment for potential confounding risk factors, NE after TJA was significantly associated with an increased mortality (p < 0.001), a longer hospital stay (p < 0.001), and higher total hospitalization charges (p < 0.001). CONCLUSIONS: These data demonstrated that NE in TJA patients was predictive of an increased mortality, length of hospital stay, and hospitalization costs. This study established baseline NE rates in the TJA patient population to use as benchmarks and identified target areas for quality improvement in US.
Identifier
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<a href="http://doi.org/10.1007/s00402-019-03156-0" target="_blank" rel="noreferrer noopener">10.1007/s00402-019-03156-0</a>
2019
Archives of orthopaedic and trauma surgery
Hospital-acquired condition
Medical quality
National Inpatient Sample
NEOMED College of Medicine Student
NEOMED Student Publications
Never events
Total hip arthroplasty
Total joint arthroplasty
Total knee arthroplasty
Tsai Allen J
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Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1007/s10865-008-9191-2" target="_blank" rel="noreferrer noopener">http://doi.org/10.1007/s10865-008-9191-2</a>
Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
223-233
Issue
3
Volume
32
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Title
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Patients' reasons for electing to undergo total knee arthroplasty impact post-operative pain severity and range of motion
Publisher
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Journal of Behavioral Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2009
2009-06
Subject
The topic of the resource
osteoarthritis; pain; Surgery; Psychology; predictors; quality-of-life; replacement; fear; fatigue; Approach-avoidance goals; chronic musculoskeletal pain; Post-operative recovery; Reasoning; Surgical outcome; Total knee arthroplasty
Creator
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Cremeans-Smith J K; Boarts J M; Greene K; Delahanty D L
Description
An account of the resource
The present study examines the reasons cited by 103 patients for their electing to undergo total knee arthroplastic surgery and the relationship between these reasons and their post-operative pain and range of motion. Results suggest that individuals who describe different reasons for undergoing surgery vary in their post-operative recovery. Specifically, patients who cite pain as the reason they are undergoing surgery report greater levels of pain during the early post-operative period. In contrast, patients who describe goals of regaining mobility or a specific activity as their reason for undergoing surgery achieve a greater range of motion during early post-operative physical therapy. Individuals who express avoidance goals for undergoing total knee arthroplasty report more severe post-operative pain at 1 and 3 months following surgery compared to patients who express approach goals. Interventions targeted towards patients reporting pre-operative pain or avoidance goals may decrease subsequent post-operative pain and increase mobility.
Identifier
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<a href="http://doi.org/10.1007/s10865-008-9191-2" target="_blank" rel="noreferrer noopener">10.1007/s10865-008-9191-2</a>
Format
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Journal Article or Conference Abstract Publication
2009
Approach-avoidance goals
Boarts J M
chronic musculoskeletal pain
Cremeans-Smith J K
Delahanty D L
fatigue
Fear
Greene K
Journal Article or Conference Abstract Publication
Journal of Behavioral Medicine
Osteoarthritis
Pain
Post-operative recovery
predictors
Psychology
quality-of-life
Reasoning
Replacement
Surgery
Surgical outcome
Total knee arthroplasty