Patient “No-Show” Prior to Elective Primary Total Hip Arthroplasty Increases Risk of Postoperative Anemia
Background: Patients who “no-show” (NS) clinical appointments are at a higher risk of poor healthcare outcomes. The objective of this study was to evaluate and characterize the relationship between patient NS prior to primary total hip arthroplasty (THA) and 90-day complication risk after THA. Metho...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-02-01
|
| Series: | Arthroplasty Today |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344124002875 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823861158899089408 |
|---|---|
| author | Jeffrey S. Mun, BA Matthew W. Parry, MD, MS Alex Tang, MD Jesse J. Manikowski, MS Cory Crinella, PA-C John J. Mercuri, MD, MA |
| author_facet | Jeffrey S. Mun, BA Matthew W. Parry, MD, MS Alex Tang, MD Jesse J. Manikowski, MS Cory Crinella, PA-C John J. Mercuri, MD, MA |
| author_sort | Jeffrey S. Mun, BA |
| collection | DOAJ |
| description | Background: Patients who “no-show” (NS) clinical appointments are at a higher risk of poor healthcare outcomes. The objective of this study was to evaluate and characterize the relationship between patient NS prior to primary total hip arthroplasty (THA) and 90-day complication risk after THA. Methods: We retrospectively reviewed 4147 patients undergoing primary THA. Patients were divided based on whether they NS at least 1 appointment vs always attend (AA) appointments. Information collected included number of NS and attended appointments, demographics, comorbidities, and 90-day postoperative complications. Regression analyses were run to identify relationships between NS status and postoperative outcomes, as well as factors that would predict NS status. Results: Compared to AA patients, NS patients had an increased odds of a postoperative complication (odds ratio:1.3, P = .0005), specifically postoperative anemia (odds ratio: 1.3, P = .0004). When comparing NS and AA patients who both experienced postoperative anemia-related complications, the NS patients had significantly greater intraoperative blood loss compared to AA patients (mean ± standard deviation: 412.6 mL ± 310.2 vs 357.3 mL ± 269.0, P = .028). NS patients also had a greater rate of symptomatic anemia compared to AA patients (100 [3%] vs 25 cases [2%], P = .018). Age, smoking status, gender, race, body mass index, Charlson Comorbidity Index, and insurance status were independent predictors of missing clinical appointments. Conclusions: There was an increased risk for complications, specifically anemia-related complications, in THA patients who NS preoperatively. Demographic factors were independently associated with higher odds of missing a scheduled clinical appointment. The results suggest orthopedic surgeons should consider NS data to pre-emptively assess risk for complications following THA. Level of Evidence: Level III. |
| format | Article |
| id | doaj-art-1413a521fa4f4b9b905d8ecedd335ec4 |
| institution | Kabale University |
| issn | 2352-3441 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj-art-1413a521fa4f4b9b905d8ecedd335ec42025-02-10T04:34:31ZengElsevierArthroplasty Today2352-34412025-02-0131101602Patient “No-Show” Prior to Elective Primary Total Hip Arthroplasty Increases Risk of Postoperative AnemiaJeffrey S. Mun, BA0Matthew W. Parry, MD, MS1Alex Tang, MD2Jesse J. Manikowski, MS3Cory Crinella, PA-C4John J. Mercuri, MD, MA5Geisinger Commonwealth School of Medicine, Scranton, PA, USA; Corresponding author. Geisinger Commonwealth School of Medicine, 525 Pine Street, Scranton, PA 18509, USA. Tel.: +1 610 888 6549.Geisinger Musculoskeletal Institute, Division of Adult Reconstruction, Scranton, PA, USAGeisinger Musculoskeletal Institute, Division of Adult Reconstruction, Scranton, PA, USAGeisinger Cancer Institute, Center for Oncology Research and Innovation, Danville, PA, USAGeisinger Musculoskeletal Institute, Division of Adult Reconstruction, Scranton, PA, USAGeisinger Musculoskeletal Institute, Division of Adult Reconstruction, Scranton, PA, USABackground: Patients who “no-show” (NS) clinical appointments are at a higher risk of poor healthcare outcomes. The objective of this study was to evaluate and characterize the relationship between patient NS prior to primary total hip arthroplasty (THA) and 90-day complication risk after THA. Methods: We retrospectively reviewed 4147 patients undergoing primary THA. Patients were divided based on whether they NS at least 1 appointment vs always attend (AA) appointments. Information collected included number of NS and attended appointments, demographics, comorbidities, and 90-day postoperative complications. Regression analyses were run to identify relationships between NS status and postoperative outcomes, as well as factors that would predict NS status. Results: Compared to AA patients, NS patients had an increased odds of a postoperative complication (odds ratio:1.3, P = .0005), specifically postoperative anemia (odds ratio: 1.3, P = .0004). When comparing NS and AA patients who both experienced postoperative anemia-related complications, the NS patients had significantly greater intraoperative blood loss compared to AA patients (mean ± standard deviation: 412.6 mL ± 310.2 vs 357.3 mL ± 269.0, P = .028). NS patients also had a greater rate of symptomatic anemia compared to AA patients (100 [3%] vs 25 cases [2%], P = .018). Age, smoking status, gender, race, body mass index, Charlson Comorbidity Index, and insurance status were independent predictors of missing clinical appointments. Conclusions: There was an increased risk for complications, specifically anemia-related complications, in THA patients who NS preoperatively. Demographic factors were independently associated with higher odds of missing a scheduled clinical appointment. The results suggest orthopedic surgeons should consider NS data to pre-emptively assess risk for complications following THA. Level of Evidence: Level III.http://www.sciencedirect.com/science/article/pii/S2352344124002875No-showIdentification of high-risk patientsHealth disparitiesTotal hip arthroplasty |
| spellingShingle | Jeffrey S. Mun, BA Matthew W. Parry, MD, MS Alex Tang, MD Jesse J. Manikowski, MS Cory Crinella, PA-C John J. Mercuri, MD, MA Patient “No-Show” Prior to Elective Primary Total Hip Arthroplasty Increases Risk of Postoperative Anemia Arthroplasty Today No-show Identification of high-risk patients Health disparities Total hip arthroplasty |
| title | Patient “No-Show” Prior to Elective Primary Total Hip Arthroplasty Increases Risk of Postoperative Anemia |
| title_full | Patient “No-Show” Prior to Elective Primary Total Hip Arthroplasty Increases Risk of Postoperative Anemia |
| title_fullStr | Patient “No-Show” Prior to Elective Primary Total Hip Arthroplasty Increases Risk of Postoperative Anemia |
| title_full_unstemmed | Patient “No-Show” Prior to Elective Primary Total Hip Arthroplasty Increases Risk of Postoperative Anemia |
| title_short | Patient “No-Show” Prior to Elective Primary Total Hip Arthroplasty Increases Risk of Postoperative Anemia |
| title_sort | patient no show prior to elective primary total hip arthroplasty increases risk of postoperative anemia |
| topic | No-show Identification of high-risk patients Health disparities Total hip arthroplasty |
| url | http://www.sciencedirect.com/science/article/pii/S2352344124002875 |
| work_keys_str_mv | AT jeffreysmunba patientnoshowpriortoelectiveprimarytotalhiparthroplastyincreasesriskofpostoperativeanemia AT matthewwparrymdms patientnoshowpriortoelectiveprimarytotalhiparthroplastyincreasesriskofpostoperativeanemia AT alextangmd patientnoshowpriortoelectiveprimarytotalhiparthroplastyincreasesriskofpostoperativeanemia AT jessejmanikowskims patientnoshowpriortoelectiveprimarytotalhiparthroplastyincreasesriskofpostoperativeanemia AT corycrinellapac patientnoshowpriortoelectiveprimarytotalhiparthroplastyincreasesriskofpostoperativeanemia AT johnjmercurimdma patientnoshowpriortoelectiveprimarytotalhiparthroplastyincreasesriskofpostoperativeanemia |