Risk of re-admission, reoperation, and mortality within 90 days of total hip and knee arthroplasty in fast-track departments in Denmark from 2005 to 2011

Figures & data

Figure 1. The 6 orthopedic departments supported by the Lundbeck Foundation Center for Fast-track Hip and Knee Replacement that formed the fast-track cohort.

Figure 2. 79,098 total hip and knee arthroplasties were included in the study. The fast-track cohort consisted of 17,284 arthroplasties. The national comparison cohort consisted of 61,814 arthroplasties.

Table 1a. Patient characteristics according to cohort and time period

	Age		Sex		LOS		Type of fixation ^a
	Mean (SD)	p-value	Female %	p-value	Median (10–90%)	p-value	THA %	p-value	TKA %	p-value
2005–2007
Fast-track	69 (10)	< 0.001	58	0.02	4 (2–8)	< 0.001	19/59/22	< 0.001	91/0/9	< 0.001
National	69 (10)		60		6 (3–10)		32/47/22		76/10/14
2008–2009
Fast-track	68 (10)	< 0.001	58	0.1	3 (2–9)	< 0.001	10/65/25	< 0.001	89/3/8	< 0.001
National	69 (10)		59		4 (2–7)		19/66/15		81/6/13
2010–Sept. 2011
Fast-track	69 (10)	0.1	57	0.01	3 (2–5)	< 0.001	5/66/29	< 0.001	91/5/4	< 0.001
National	69 (9)		59		3 (2–7)		18/71/11		77/4/19

^a cemented/uncemented/hybrid

Table 1b. Charlson comorbidity index distribution (percent) in fast-track and national comparison cohorts according to time period

	Comorbidity index
	0	1–2	≥ 3	p-value
2005–2007
Fast-track	61	31	8	0.1
National	62	30	8
2008–2009
Fast-track	59	31	10	0.2
National	60	31	9
2010–Sept. 2011
Fast-track	57	33	10	0.2
National	57	33	10

Table 2. Absolute risk of mortality, reoperation, and re-admission due to infection or thromboembolic event according to cohort and time period. All 90 days postoperatively

	n	Risk % (95% CI)	p-value
Re-admission due to infection
2005–2007
Fast-track	168	2.6 (2.2–3.0)	0.01
National	500	2.0 (1.8–2.2)
2008–2009
Fast-track	119	2.1 (1.7–2.5)	0.4
National	368	1.9 (1.7–2.1)
2010–Sept. 2011
Fast-track	102	2.0 (1.7–2.5)	0.6
National	336	1.9 (1.7–2.2)
Re-admission due to thromboembolic event
2005–2007
Fast-track	131	2.0 (1.7–2.4)	0.2
National	557	2.2 (2.1–2.4)
2008–2009
Fast-track	120	2.1 (1.7–2.5)	0.8
National	397	2.0 (1.8–2.2)
2010–Sept. 2011
Fast-track	82	1.7 (1.3–2.0)	0.01
National	385	2.2 (2.0–2.5)
Reoperation
2005–2007
Fast-track	111	1.7 (1.4–2.0)	0.8
National	407	1.6 (1.5–1.8)
2008–2009
Fast-track	117	2.0 (1.7–2.4)	0.3
National	354	1.8 (1.6–2.0)
2010–Sept. 2011
Fast-track	69	1.4 (1.1–1.8)	0.5
National	261	1.5 (1.3–1.7)
Mortality
2005–2007
Fast-track	33	0.5 (0.3–0.7)	0.6
National	114	0.5 (0.4–0.6)
2008–2009
Fast-track	31	0.5 (0.4–0.8)	0.2
National	79	0.4 (0.3–0.5)
2010–Sept. 2011
Fast-track	19	0.4 (0.2–0.6)	0.4
National	81	0.5 (0.4–0.6)

Table 3. Relative risk of mortality, reoperation, and re-admission due to infection or thromboembolic event in the fast-track cohort according to time period. All 90 days postoperatively

	Adjusted RR ^a	p-value
Re-admission due to infection
2005–2007	1.3 (1.1–1.6)	< 0.01
2008–2009	1.1 (0.9–1.4)	0.3
2010–Sept. 2011	1.1 (0.8–1.3)	0.7
Re-admission due to thromboembolic event
2005–2007	0.9 (0.8–1.1)	0.3
2008–2009	1.0 (0.8–1.3)	0.7
2010–Sept. 2011	0.7 (0.6–0.9)	0.01
Reoperation
2005–2007	1.0 (0.8–1.3)	0.7
2008–2009	1.1 (0.9–1.4)	0.3
2010–Sept. 2011	0.9 (0.7–1.2)	0.5
Mortality
2005–2007	1.2 (0.8–1.7)	0.5
2008–2009	1.3 (0.8–2.0)	0.3
2010–Sept. 2011	0.8 (0.5–1.4)	0.4

^aOR for re-admission and reoperation, HR for mortality.