Hunt, L.P., Blom, A. and Wilkinson, J.M. orcid.org/0000-0001-5577-3674 (2017) An analysis of 30-day mortality after weekend versus weekday elective joint arthroplasty in England and Wales: a cohort study using the National Joint Registry Dataset. Bone and Joint Journal , 99-B (12). pp. 1618-1628. ISSN 2049-4394
Abstract
AIMS: To investigate whether elective joint arthroplasty performed at the weekend is associated with a different 30-day mortality versus that performed between Monday and Friday. PATIENTS AND METHODS: We examined the 30-day cumulative mortality rate (Kaplan-Meier) for all elective hip and knee arthroplasties performed in England and Wales between 1st April 2003 and 31st December 2014, comprising 118 096 episodes undertaken at the weekend and 1 233 882 episodes performed on a weekday. We used Cox proportional-hazards regression models to assess for time-dependent variation and adjusted for identified risk factors for mortality. RESULTS: The cumulative 30-day mortality for hip arthroplasty was 0.15% (95% confidence interval (CI) 0.12 to 0.19) for patients operated on at the weekend versus 0.20% (95% CI 0.19 to 0.21) for patients undergoing surgery during the normal working week. For knee arthroplasty, the cumulative 30-day mortality was 0.14% (95% CI 0.11 to 0.17) for weekend-operated patients versus 0.18% (95% CI 0.17 to 0.19) for weekday-operated patients. These differences were independent of any differences in patient age, gender, American Society of Anaesthesiologists grade, surgeon seniority, surgical and anaesthetic practices, and thromboprophylaxis choice in weekend versus weekday-operated patients. CONCLUSION: The 30-day mortality rate after elective joint arthroplasty is low. Surgery performed at the weekend is associated with lower post-operative mortality versus operations performed on a weekday.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | ©2017 The British Editorial Society of Bone & Joint Surgery. This is an author produced version of a paper subsequently published in Bone and Joint Journal. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Hip; Joint arthroplasty; Knee; Mortality; Weekend |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > The Medical School (Sheffield) > Division of Genomic Medicine (Sheffield) > Department of Oncology and Metabolism (Sheffield) The University of Sheffield > Sheffield Teaching Hospitals |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 19 Dec 2017 15:50 |
Last Modified: | 01 Dec 2018 01:38 |
Published Version: | https://doi.org/10.1302/0301-620X.99B12.BJJ-2017-0... |
Status: | Published |
Publisher: | British Editorial Society of Bone and Joint Surgery |
Refereed: | Yes |
Identification Number: | 10.1302/0301-620X.99B12.BJJ-2017-0347.R1 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:125159 |