Quality measures for total ankle replacement, 30-day readmission and reoperation rates within 1 year of surgery:A data linkage study using the NJR data set

Zaidi, Razi, Macgregor, Alexander J ORCID: https://orcid.org/0000-0003-2163-2325 and Goldberg, Andy (2016) Quality measures for total ankle replacement, 30-day readmission and reoperation rates within 1 year of surgery:A data linkage study using the NJR data set. BMJ Open, 6 (5). ISSN 2044-6055

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Abstract

Objective: To report on the rate of 30-day readmission and the rate of additional or revision surgery within 12 months following total ankle replacement (TAR).  Design: A data-linkage study of the UK National Joint Registry (NJR) data and Hospital Episodes Statistics (HES) database. These two databases were linked in a deterministic fashion. HES episodes 12 months following the index procedure were isolated and analysed. Logistic regression was used to model predictors of reoperation and revision for primary ankle replacement.  Participants: All patients who underwent primary and revision ankle replacements according to the NJR between February 2008 and February 2013.  Results: The rate of 30-day readmission following primary and revision ankle replacement was 2.2% and 1.3%, respectively. In the 12 months following primary and revision ankle replacements, the revision rate (where implants needed to be removed) was 1.2% with increased odds in those orthopaedic units preforming <20 ankle replacements per year and patients with a preoperative fixed equinus deformity. The reoperation other than revision (where implants were not removed) in the 12 months following primary and revision TARs was 6.6% and 9.3%, respectively. Rheumatoid arthritis, cemented prosthesis and high ASA grade significantly increased the odds of reoperation.  Conclusions: TAR has a 30-day readmission rate of 2.2%, which is similar to that of knee replacement but lower than that of total hip replacement. 6.6% of patients undergoing primary TAR require a reoperation within 12 months of the index procedure. Early revision rates are significantly higher in low-volume centres.

Item Type:	Article
Additional Information:	This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Musculoskeletal Medicine Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health Faculty of Medicine and Health Sciences > Research Groups > Nutrition and Preventive Medicine Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
Depositing User:	Pure Connector
Date Deposited:	31 May 2016 09:00
Last Modified:	20 Apr 2023 00:04
URI:	https://ueaeprints.uea.ac.uk/id/eprint/59135
DOI:	10.1136/bmjopen-2016-011332

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