Table 2 Comparison of patient demographics per quarter for elective THA
Quarter of Operation | 2019 | 2020 | P Value | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 1 | 2 | 3 | 4 | |||
Number of Patients | 10,591 | 11,360 | 10,987 | 10,729 | 9448 | 5331 | 10,451 | 8900 | ||
Age Cohorts | < 40 | 204 (1.9) | 217 (1.9) | 208 (1.9) | 240 (2.2) | 185 (2.0) | 124 (2.3) | 207 (2.0) | 179 (2.0) | < 0.001 |
40–44 | 178 (1.7) | 209 (1.8) | 188 (1.7) | 199 (1.9) | 171 (1.8) | 92 (1.7) | 174 (1.7) | 174 (2.0) | ||
45–49 | 377 (3.6) | 387 (3.4) | 374 (3.4) | 420 (3.9) | 294 (3.1) | 184 (3.5) | 325 (3.1) | 338 (3.8) | ||
50–54 | 720 (6.8) | 762 (6.7) | 745 (6.8) | 742 (6.9) | 637 (6.7) | 396 (7.4) | 676 (6.5) | 667 (7.5) | ||
55–59 | 1302 (12.3) | 1386 (12.2) | 1293 (11.8) | 1393 (13.0) | 1098 (11.6) | 753 (14.1) | 1220 (11.7) | 1141 (12.8) | ||
60–64 | 1785 (16.9) | 1927 (17.0) | 1809 (16.5) | 1870 (17.4) | 1550 (16.4) | 868 (16.3) | 1771 (16.9) | 1567 (17.6) | ||
65–69 | 1968 (18.6) | 2059 (18.1) | 2016 (18.3) | 1926 (18.0) | 1869 (19.8) | 1007 (18.9) | 1917 (18.3) | 1696 (19.1) | ||
70–74 | 1817 (17.2) | 1929 (17.0) | 1966 (17.9) | 1728 (16.1) | 1586 (16.8) | 904 (17.0) | 1870 (17.9) | 1437 (16.1) | ||
75–79 | 1167 (11.0) | 1289 (11.3) | 1295 (11.8) | 1236 (11.5) | 1095 (11.6) | 539 (10.1) | 1230 (11.8) | 930 (10.4) | ||
80–84 | 702 (6.6) | 780 (6.9) | 706 (6.4) | 629 (5.9) | 582 (6.2) | 308 (5.8) | 679 (6.5) | 512 (5.8) | ||
85 + | 371 (3.5) | 415 (3.7) | 387 (3.5) | 346 (3.2) | 381 (4.0) | 156 (2.9) | 382 (3.7) | 259 (2.9) | ||
Gender | female | 5610 (53.0) | 6322 (55.7) | 6159 (56.1) | 5651 (52.7) | 5090 (53.9) | 2863 (53.7) | 5716 (54.7) | 4699 (52.8) | < 0.001 |
male | 4981 (47.0) | 5038 (44.3) | 4828 (43.9) | 5078 (47.3) | 4358 (46.1) | 2468 (46.3) | 4735 (45.3) | 4201 (47.2) | ||
Race | American Indian or Alaska Native | 38 (.4) | 41 (.4) | 40 (.4) | 44 (.4) | 42 (.4) | 33 (.6) | 38 (.4) | 39 (.4) | < 0.001 |
Asian | 140 (1.3) | 169 (1.5) | 141 (1.3) | 144 (1.3) | 133 (1.4) | 121 (2.3) | 229 (2.2) | 226 (2.5) | ||
Black or African American | 833 (7.9) | 968 (8.5) | 946 (8.6) | 889 (8.3) | 809 (8.6) | 405 (7.6) | 955 (9.1) | 844 (9.5) | ||
Native Hawaiian or Pacific Islander | 20 (.2) | 16 (.1) | 23 (.2) | 15 (.1) | 33 (.3) | 12 (.2) | 16 (.2) | 14 (.2) | ||
Some Other Race | 0 (.0) | 0 (.0) | 0 (.0) | 0 (.0) | 2 (.0) | 0 (.0) | 10 (.1) | 20 (.2) | ||
Unknown/Not Reported | 2538 (24.0) | 2662 (23.4) | 2579 (23.5) | 2663 (24.8) | 2156 (22.8) | 795 (14.9) | 2326 (22.3) | 2062 (23.2) | ||
White | 7022 (66.3) | 7504 (66.1) | 7258 (66.1) | 6974 (65.0) | 6273 (66.4) | 3965 (74.4) | 6877 (65.8) | 5695 (64.0) | ||
BMI Category | < 18.5 | 70 (.7) | 99 (.9) | 87 (.8) | 75 (.7) | 77 (.8) | 37 (.7) | 93 (.9) | 83 (.9) | 0.444 |
18.5–24.9 | 1882 (17.8) | 2022 (17.8) | 1883 (17.1) | 1861 (17.3) | 1633 (17.3) | 972 (18.2) | 1913 (18.3) | 1611 (18.1) | ||
25.0–29.9 | 3542 (33.4) | 3682 (32.4) | 3682 (33.5) | 3559 (33.2) | 3054 (32.3) | 1742 (32.7) | 3400 (32.5) | 2896 (32.5) | ||
30.0–34.9 | 2811 (26.5) | 3005 (26.5) | 2925 (26.6) | 2894 (27.0) | 2611 (27.6) | 1424 (26.7) | 2687 (25.7) | 2356 (26.5) | ||
35.0–39.9 | 1473 (13.9) | 1671 (14.7) | 1562 (14.2) | 1527 (14.2) | 1377 (14.6) | 721 (13.5) | 1508 (14.4) | 1265 (14.2) | ||
40.0 + | 756 (7.1) | 823 (7.2) | 785 (7.1) | 760 (7.1) | 650 (6.9) | 373 (7.0) | 757 (7.2) | 619 (7.0) | ||
Diabetes mellitus | Insulin Dependent | 298 (2.8) | 318 (2.8) | 340 (3.1) | 326 (3.0) | 264 (2.8) | 136 (2.6) | 319 (3.1) | 247 (2.8) | 0.389 |
No | 9303 (87.8) | 9928 (87.4) | 9625 (87.6) | 9407 (87.7) | 8304 (87.9) | 4720 (88.5) | 9121 (87.3) | 7765 (87.2) | ||
Non-Insulin Dependent | 990 (9.3) | 1114 (9.8) | 1022 (9.3) | 996 (9.3) | 880 (9.3) | 475 (8.9) | 1011 (9.7) | 888 (10.0) | ||
Current smoker | No | 9346 (88.2) | 10,069 (88.6) | 9669 (88.0) | 9537 (88.9) | 8374 (88.6) | 4785 (89.8) | 9270 (88.7) | 7862 (88.3) | 0.054 |
Yes | 1245 (11.8) | 1291 (11.4) | 1318 (12.0) | 1192 (11.1) | 1074 (11.4) | 546 (10.2) | 1181 (11.3) | 1038 (11.7) | ||
Dyspnea | At Rest | 15 (.1) | 13 (.1) | 12 (.1) | 12 (.1) | 9 (.1) | 6 (.1) | 11 (.1) | 11 (.1) | 0.007 |
Moderate Exertion | 488 (4.6) | 514 (4.5) | 519 (4.7) | 480 (4.5) | 406 (4.3) | 161 (3.0) | 446 (4.3) | 392 (4.4) | ||
No | 10,088 (95.3) | 10,833 (95.4) | 10,456 (95.2) | 10,237 (95.4) | 9033 (95.6) | 5164 (96.9) | 9994 (95.6) | 8497 (95.5) | ||
Functional health status | Independent | 10,380 (98.0) | 11,105 (97.8) | 10,744 (97.8) | 10,526 (98.1) | 9264 (98.1) | 5244 (98.4) | 10,230 (97.9) | 8693 (97.7) | < 0.001 |
Partially Dependent | 144 (1.4) | 153 (1.3) | 139 (1.3) | 134 (1.2) | 136 (1.4) | 73 (1.4) | 190 (1.8) | 158 (1.8) | ||
Totally Dependent | 5 (.0) | 7 (.1) | 8 (.1) | 5 (.0) | 5 (.1) | 7 (.1) | 12 (.1) | 13 (.1) | ||
Unknown | 62 (.6) | 95 (.8) | 96 (.9) | 64 (.6) | 43 (.5) | 7 (.1) | 19 (.2) | 36 (.4) | ||
History of Severe COPD | No | 10,214 (96.4) | 10,938 (96.3) | 10,538 (95.9) | 10,336 (96.3) | 9127 (96.6) | 5168 (96.9) | 10,019 (95.9) | 8609 (96.7) | 0.001 |
Yes | 377 (3.6) | 422 (3.7) | 449 (4.1) | 393 (3.7) | 321 (3.4) | 163 (3.1) | 432 (4.1) | 291 (3.3) | ||
Congestive heart failure (CHF) | No | 10,556 (99.7) | 11,297 (99.4) | 10,947 (99.6) | 10,683 (99.6) | 9408 (99.6) | 5311 (99.6) | 10,401 (99.5) | 8866 (99.6) | 0.241 |
Yes | 35 (.3) | 63 (.6) | 40 (.4) | 46 (.4) | 40 (.4) | 20 (.4) | 50 (.5) | 34 (.4) | ||
Hypertension | No | 4870 (46.0) | 5044 (44.4) | 4852 (44.2) | 4977 (46.4) | 4306 (45.6) | 2456 (46.1) | 4702 (45.0) | 4079 (45.8) | 0.007 |
Yes | 5721 (54.0) | 6316 (55.6) | 6135 (55.8) | 5752 (53.6) | 5142 (54.4) | 2875 (53.9) | 5749 (55.0) | 4821 (54.2) | ||
Currently on dialysis (pre-op) | No | 10,575 (99.8) | 11,338 (99.8) | 10,966 (99.8) | 10,709 (99.8) | 9431 (99.8) | 5317 (99.7) | 10,432 (99.8) | 8877 (99.7) | 0.734 |
Yes | 16 (.2) | 22 (.2) | 21 (.2) | 20 (.2) | 17 (.2) | 14 (.3) | 19 (.2) | 23 (.3) | ||
Steroid use for chronic condition | No | 10,221 (96.5) | 10,978 (96.6) | 10,605 (96.5) | 10,366 (96.6) | 9127 (96.6) | 5155 (96.7) | 10,081 (96.5) | 8592 (96.5) | 0.993 |
Yes | 370 (3.5) | 382 (3.4) | 382 (3.5) | 363 (3.4) | 321 (3.4) | 176 (3.3) | 370 (3.5) | 308 (3.5) | ||
> 10% loss body weight in last 6 months | No | 10,574 (99.8) | 11,337 (99.8) | 10,965 (99.8) | 10,707 (99.8) | 9428 (99.8) | 5316 (99.7) | 10,425 (99.8) | 8884 (99.8) | 0.804 |
Yes | 17 (.2) | 23 (.2) | 22 (.2) | 22 (.2) | 20 (.2) | 15 (.3) | 26 (.2) | 16 (.2) | ||
Bleeding disorders | No | 10,438 (98.6) | 11,170 (98.3) | 10,772 (98.0) | 10,537 (98.2) | 9274 (98.2) | 5235 (98.2) | 10,243 (98.0) | 8739 (98.2) | 0.088 |
Yes | 153 (1.4) | 190 (1.7) | 215 (2.0) | 192 (1.8) | 174 (1.8) | 96 (1.8) | 208 (2.0) | 161 (1.8) | ||
mFI | 0 | 4499 (42.5) | 4637 (40.8) | 4469 (40.7) | 4557 (42.5) | 3964 (42.0) | 2269 (42.6) | 4312 (41.3) | 3733 (41.9) | 0.013 |
1 | 4715 (44.5) | 5171 (45.5) | 5028 (45.8) | 4793 (44.7) | 4261 (45.1) | 2415 (45.3) | 4651 (44.5) | 3982 (44.7) | ||
2 | 1285 (12.1) | 1442 (12.7) | 1373 (12.5) | 1284 (12.0) | 1144 (12.1) | 609 (11.4) | 1359 (13.0) | 1093 (12.3) | ||
3 | 84 (.8) | 102 (.9) | 109 (1.0) | 91 (.8) | 77 (.8) | 36 (.7) | 122 (1.2) | 84 (.9) | ||
4 | 7 (.1) | 8 (.1) | 8 (.1) | 2 (.0) | 2 (.0) | 2 (.0) | 7 (.1) | 8 (.1) | ||
5 | 1 (.0) | 0 (.0) | 0 (.0) | 2 (.0) | 0 (.0) | 0 (.0) | 0 (.0) | 0 (.0) | ||
Inpatient/outpatient | Inpatient | 10,119 (95.5) | 10,756 (94.7) | 10,336 (94.1) | 9951 (92.7) | 7249 (76.7) | 3273 (61.4) | 6380 (61.0) | 5075 (57.0) | < 0.001 |
Outpatient | 472 (4.5) | 604 (5.3) | 651 (5.9) | 778 (7.3) | 2199 (23.3) | 2058 (38.6) | 4071 (39.0) | 3825 (43.0) | ||
ASA classification | 1-No Disturbance | 354 (3.3) | 374 (3.3) | 311 (2.8) | 380 (3.5) | 291 (3.1) | 155 (2.9) | 270 (2.6) | 288 (3.2) | < 0.001 |
2-Mild Disturbance | 5417 (51.1) | 5711 (50.3) | 5591 (50.9) | 5460 (50.9) | 4766 (50.4) | 2849 (53.4) | 5113 (48.9) | 4582 (51.5) | ||
3-Severe Disturbance | 4655 (44.0) | 5031 (44.3) | 4872 (44.3) | 4715 (43.9) | 4195 (44.4) | 2233 (41.9) | 4825 (46.2) | 3848 (43.2) | ||
4-Life Threat | 155 (1.5) | 231 (2.0) | 202 (1.8) | 171 (1.6) | 194 (2.1) | 94 (1.8) | 234 (2.2) | 168 (1.9) | ||
Principal anesthesia technique | Epidural | 53 (.5) | 65 (.6) | 69 (.6) | 79 (.7) | 42 (.4) | 47 (.9) | 90 (.9) | 43 (.5) | < 0.001 |
General | 4366 (41.2) | 4584 (40.4) | 4501 (41.0) | 4331 (40.4) | 3689 (39.0) | 2171 (40.7) | 3981 (38.1) | 3308 (37.2) | ||
MAC/IV Sedation | 2173 (20.5) | 2287 (20.1) | 2283 (20.8) | 2220 (20.7) | 2202 (23.3) | 1133 (21.3) | 2465 (23.6) | 2162 (24.3) | ||
Regional | 110 (1.0) | 127 (1.1) | 131 (1.2) | 141 (1.3) | 162 (1.7) | 116 (2.2) | 210 (2.0) | 175 (2.0) | ||
Spinal | 3879 (36.6) | 4287 (37.7) | 3999 (36.4) | 3946 (36.8) | 3346 (35.4) | 1859 (34.9) | 3698 (35.4) | 3206 (36.0) | ||
Other | 10 (0.1) | 10 (0.1) | 4 (0.0) | 12 (0.1) | 7 (0.1) | 5 (0.1) | 7 (0.1) | 6 (0.1) | ||
Total operation time (minutes) | 89.37 | 89.48 | 89.99 | 90.4 | 90.59 | 91.93 | 91.85 | 92.39 | < 0.001 | |
Length of hospital stay (days) | 1.86 | 1.79 | 1.76 | 1.68 | 1.68 | 1.48 | 1.52 | 1.48 | < 0.001 | |
Length of Stay (days) | 0 | 899 (8.5) | 1066 (9.4) | 1072 (9.8) | 1195 (11.1) | 1057 (11.2) | 1074 (20.1) | 1869 (17.9) | 1854 (20.8) | < 0.001 |
1 | 4518 (42.7) | 4969 (43.7) | 4997 (45.5) | 5081 (47.4) | 4746 (50.2) | 2686 (50.4) | 5245 (50.2) | 4435 (49.8) | ||
≥ 2 | 5158 (48.7) | 5320 (46.8) | 4912 (44.7) | 4450 (41.5) | 3637 (38.5) | 1571 (29.5) | 3336 (31.9) | 2609 (29.3) | ||