Older Adults Undergoing Total Hip or Knee Arthroplasty: Chronicling Changes in Their Multimorbidity Profile in the Last Two Decades

Siran M. Koroukian, Nicholas K. Schiltz, David F. Warner, Alison K. Klika, Carlos A. Higuera-Rueda, Wael K. Barsoum

Research output: Contribution to journalArticle

Abstract

Background: Despite the ubiquitous use of total hip arthroplasty (THA) and total knee arthroplasty (TKA) in older adults, little is known about the multimorbidity (MM) profile of this patient population. This study evaluates the temporal trends of MM, hypothesizing that patients with MM have had an increasingly greater representation in THA and TKA patients over time. Methods: Data on a US representative sample of older adults from the linked Health and Retirement Study and Medicare data from 1993 to 2012 were used. The Health and Retirement Study is a biennial survey that collects data on a broad array of measures, including self-reported chronic conditions and geriatric syndromes, which were used to account for MM. Medicare data were used to identify fee-for-service Medicare beneficiaries who underwent THA (n = 479) or TKA (n = 998) during the study years, which were grouped into 3 periods: 1993-1999, 2000-2006, and 2007-2012. Multivariable logistic regression analysis was conducted to obtain age-, gender-, and race-adjusted time trends for MM. Results: Compared to the earliest study period, and for both THA and TKA patients, there were significantly fewer patients with stroke and/or poor cognitive performance in the most recent study period. In addition, more TKA than THA patients presented with 2+ chronic conditions. Nearly 70% presented with co-occurring chronic conditions and geriatric syndromes, and this percentage did not change significantly over time. Conclusion: The high representation of THA and TKA patients presenting with co-occurring chronic conditions and geriatric syndromes in this patient population warrants detailed exploration of the effects of geriatric syndromes on postoperative outcomes.

Original languageEnglish (US)
Pages (from-to)976-982
Number of pages7
JournalJournal of Arthroplasty
Volume33
Issue number4
DOIs
StatePublished - Apr 2018

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Knee Replacement Arthroplasties
Comorbidity
Hip
Arthroplasty
Geriatrics
Medicare
Retirement
Fee-for-Service Plans
Health
Population
Logistic Models
Stroke
Regression Analysis

Keywords

  • chronic conditions
  • functional limitations
  • geriatric syndromes
  • multimorbidity
  • total hip arthroplasty
  • total knee arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Older Adults Undergoing Total Hip or Knee Arthroplasty : Chronicling Changes in Their Multimorbidity Profile in the Last Two Decades. / Koroukian, Siran M.; Schiltz, Nicholas K.; Warner, David F.; Klika, Alison K.; Higuera-Rueda, Carlos A.; Barsoum, Wael K.

In: Journal of Arthroplasty, Vol. 33, No. 4, 04.2018, p. 976-982.

Research output: Contribution to journalArticle

Koroukian, Siran M. ; Schiltz, Nicholas K. ; Warner, David F. ; Klika, Alison K. ; Higuera-Rueda, Carlos A. ; Barsoum, Wael K. / Older Adults Undergoing Total Hip or Knee Arthroplasty : Chronicling Changes in Their Multimorbidity Profile in the Last Two Decades. In: Journal of Arthroplasty. 2018 ; Vol. 33, No. 4. pp. 976-982.
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abstract = "Background: Despite the ubiquitous use of total hip arthroplasty (THA) and total knee arthroplasty (TKA) in older adults, little is known about the multimorbidity (MM) profile of this patient population. This study evaluates the temporal trends of MM, hypothesizing that patients with MM have had an increasingly greater representation in THA and TKA patients over time. Methods: Data on a US representative sample of older adults from the linked Health and Retirement Study and Medicare data from 1993 to 2012 were used. The Health and Retirement Study is a biennial survey that collects data on a broad array of measures, including self-reported chronic conditions and geriatric syndromes, which were used to account for MM. Medicare data were used to identify fee-for-service Medicare beneficiaries who underwent THA (n = 479) or TKA (n = 998) during the study years, which were grouped into 3 periods: 1993-1999, 2000-2006, and 2007-2012. Multivariable logistic regression analysis was conducted to obtain age-, gender-, and race-adjusted time trends for MM. Results: Compared to the earliest study period, and for both THA and TKA patients, there were significantly fewer patients with stroke and/or poor cognitive performance in the most recent study period. In addition, more TKA than THA patients presented with 2+ chronic conditions. Nearly 70{\%} presented with co-occurring chronic conditions and geriatric syndromes, and this percentage did not change significantly over time. Conclusion: The high representation of THA and TKA patients presenting with co-occurring chronic conditions and geriatric syndromes in this patient population warrants detailed exploration of the effects of geriatric syndromes on postoperative outcomes.",
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AU - Warner, David F.

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AU - Higuera-Rueda, Carlos A.

AU - Barsoum, Wael K.

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AB - Background: Despite the ubiquitous use of total hip arthroplasty (THA) and total knee arthroplasty (TKA) in older adults, little is known about the multimorbidity (MM) profile of this patient population. This study evaluates the temporal trends of MM, hypothesizing that patients with MM have had an increasingly greater representation in THA and TKA patients over time. Methods: Data on a US representative sample of older adults from the linked Health and Retirement Study and Medicare data from 1993 to 2012 were used. The Health and Retirement Study is a biennial survey that collects data on a broad array of measures, including self-reported chronic conditions and geriatric syndromes, which were used to account for MM. Medicare data were used to identify fee-for-service Medicare beneficiaries who underwent THA (n = 479) or TKA (n = 998) during the study years, which were grouped into 3 periods: 1993-1999, 2000-2006, and 2007-2012. Multivariable logistic regression analysis was conducted to obtain age-, gender-, and race-adjusted time trends for MM. Results: Compared to the earliest study period, and for both THA and TKA patients, there were significantly fewer patients with stroke and/or poor cognitive performance in the most recent study period. In addition, more TKA than THA patients presented with 2+ chronic conditions. Nearly 70% presented with co-occurring chronic conditions and geriatric syndromes, and this percentage did not change significantly over time. Conclusion: The high representation of THA and TKA patients presenting with co-occurring chronic conditions and geriatric syndromes in this patient population warrants detailed exploration of the effects of geriatric syndromes on postoperative outcomes.

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