The University of Southampton
University of Southampton Institutional Repository

Major elective joint replacement surgery: socioeconomic variations in surgical risk, postoperative morbidity and length of stay

Hollowell, Jennifer, Grocott, Mike P.W., Hardy, Rebecca, Haddad, Fares S., Mythen, Monty G. and Raine, Rosalind (2010) Major elective joint replacement surgery: socioeconomic variations in surgical risk, postoperative morbidity and length of stay Journal of Evaluation in Clinical Practice, 16, (3), pp. 529-538. (doi:10.1111/j.1365-2753.2009.01154.x). (PMID:20210822).

Record type: Article

Abstract

BACKGROUND: Patient deprivation is associated with greater need for total hip and knee replacement surgery (THR/TKR) and a higher prevalence of risk factors for surgical complications. Our aim was to examine associations between deprivation and aspects of the inpatient episode for patients undergoing these procedures.

METHODS: We analysed socioeconomic variations in preoperative surgical risk, postoperative morbidity and length of stay for 655 patients undergoing elective THR/TKR at a large metropolitan hospital. Surgical risk was assessed using the orthopaedic version of the POSSUM scoring system, postoperative morbidity was assessed using the postoperative morbidity survey, and socioeconomic status was measured using the Index of Multiple Deprivation. We adjusted for age, sex, surgical site and primary vs. revision surgery.

RESULTS: We found only a modest, clinically insignificant socioeconomic gradient in preoperative surgical risk and no socioeconomic gradient in postoperative morbidity. There was a strong socioeconomic gradient in length of stay, but only for patients undergoing TKR. This was due to deprived patients being more likely to remain in hospital without morbidity following TKR.

CONCLUSIONS: Our findings suggest differential selection of healthier patients for surgery. Hospitals serving deprived communities may have excess, unfunded costs because of the increased length of stay of socioeconomically disadvantaged patients.

Full text not available from this repository.

More information

e-pub ahead of print date: 18 February 2010
Published date: June 2010
Keywords: joint replacement, length of stay, socioeconomic factors, surgical complications, surgical risk
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 348911
URI: http://eprints.soton.ac.uk/id/eprint/348911
ISSN: 1356-1294
PURE UUID: 037ec049-62cf-4456-a60c-8369c07ab8c6

Catalogue record

Date deposited: 25 Feb 2013 10:47
Last modified: 18 Jul 2017 04:46

Export record

Altmetrics

Contributors

Author: Jennifer Hollowell
Author: Rebecca Hardy
Author: Fares S. Haddad
Author: Monty G. Mythen
Author: Rosalind Raine

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×