| Higher comorbidity, poor functional status and higher health care utilization in veterans with prevalent total knee arthroplasty or total hip arthroplasty. | |
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MedLine Citation:
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PMID: 19517157 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The objective of this study was to compare comorbidity, functional ability, and health care utilization in veterans with total knee arthroplasty (TKA) or total hip arthroplasty (THA) versus matched control populations. A cohort of veterans using Veterans Affairs (VA) healthcare system reported limitations in six activities of daily living (ADLs; bathing, dressing, eating, walking, transferring, and using the toilet), demographics, and physician-diagnosed comorbidity. VA databases provided healthcare utilization and International Classification of Diseases-9/Common procedure terminology codes for TKA/THA. Patients were classified as: (1) primary TKA; (2) primary THA; (3) combination group (>or=1 procedure); and (4) control veteran population (no THA/TKA). Multivariable regression analyses compared the risk or counts of ADL limitation and in-/out-patient visits. After multivariable adjustment, TKA, THA or combination groups had significantly higher prevalence of the following compared to veteran controls: arthritis, diabetes, or heart disease (p < 0.0001 each), severe (>or=3) ADL limitation (33%, 42%, 42% vs. 24%; p < 0.0001), and annual hospitalization rate (24%, 19%, 26% vs. 16%, p < 0.0001). Annual outpatient surgery visits were more (2.5, 2.3, 2.3 vs. 2, p = 0.01) and risk of any mental health outpatient visit was lower (12%, 11%, 12% vs. 18%, p = 0.0039). All ADLs, except eating, were significantly more limited in arthroplasty groups (p <or= 0.0009). Severe ADL limitation was more prevalent in veterans with arthroplasty than in two age-matched US cohorts: 13.4 times in >or=65 years; and 1.2-, 1.6-, and 4-fold in >or=85, 75-84, and 65-74 years. Poorer function and higher comorbidity and utilization in veterans with TKA/THA suggest that this group is appropriate for interventions targeted at improving function and decreasing utilization. |
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Authors:
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Jasvinder A Singh; Jeffrey Sloan |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2009-06-11 |
Journal Detail:
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Title: Clinical rheumatology Volume: 28 ISSN: 1434-9949 ISO Abbreviation: Clin. Rheumatol. Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-08-05 Completed Date: 2009-10-21 Revised Date: 2013-06-02 |
Medline Journal Info:
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Nlm Unique ID: 8211469 Medline TA: Clin Rheumatol Country: Germany |
Other Details:
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Languages: eng Pagination: 1025-33 Citation Subset: IM |
Affiliation:
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Rheumatology Section, Medicine Service, VA Medical Center, Minneapolis, MN 55417, USA. Jasvinder.md@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Activities of Daily Living* Aged Aged, 80 and over Ambulatory Surgical Procedures / utilization Arthroplasty, Replacement, Hip / statistics & numerical data* Arthroplasty, Replacement, Knee / statistics & numerical data* Cohort Studies Comorbidity Databases, Factual Female Health Services / utilization* Humans Inpatients / statistics & numerical data Male Mental Health Services / utilization Middle Aged Midwestern United States / epidemiology Multivariate Analysis Prevalence Primary Health Care / utilization Risk Factors Veterans / statistics & numerical data* |
| Grant Support | |
ID/Acronym/Agency:
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1 KL2 RR024151-01/RR/NCRR NIH HHS; KL2 RR024151-01/RR/NCRR NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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