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The Journal of Hip Surgery 2020; 4(03): 149-154
DOI: 10.1055/s-0040-1715129
Original Article

Parkinson's Disease Is Associated with Increased Complications, Readmission Rates, and Costs of Care after Total Hip Arthroplasty: A Matched-Cohort Analysis

Simon Katz
1   Department of Medical Studies, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, New York
,
Kevin B. Marchand
2   Department of Orthopaedic Surgery, Lenox Hill Hospital, New York, New York
,
Rushabh M. Vakharia 
3   Department of Orthopaedic Surgery, Orthopedic Research Institute, Holy Cross Hospital, Fort Lauderdale, Florida
,
Hiba Anis
4   Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
,
Nipun Sodhi
5   Department of Orthopaedic Surgery, Long Island Jewish Medical Center, New Hyde Park, New York
,
Nicolas S. Piuzzi
4   Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
,
Michael A. Mont
2   Department of Orthopaedic Surgery, Lenox Hill Hospital, New York, New York
,
Martin W. Roche
6   Department of Orthopaedic Surgery, Holy Cross Hospital, Fort Lauderdale, Florida
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Abstract

Studies investigating the impact of Parkinson's disease (PD) on patients undergoing primary total hip arthroplasty (THA) are limited. Therefore, the purpose of this study was to investigate whether PD patients undergoing primary THA are at increased risk of: (1) medical complications; (2) implant-related complications; (3) readmissions; and (4) costs. A query was performed using an administrative claims database. Matched non-PD patients undergoing primary THA served as a control group. Non-PD patients undergoing primary THA served as a matching cohort. The query yielded 39,184 patients (PD = 9,796; control = 29,388). Pearson's chi-square tests, logistic regression analyses, and Welch's t-tests were used to test for significance between the cohorts. Patients who have PD were found to have increased odds (4.64 vs. 1.15%; odds ratio [OR]: 4.19, 95% confidence interval [CI]: 3.60–4.87, p < 0.0001) of medical complications compared with the matched cohort. PD patients had greater odds of implant-related complications (7.12 vs. 3.99; OR: 1.84, p < 0.0001). PD patients also had significantly higher odds of 90-day readmission (19.83 vs. 15.29%; OR: 1.37, 95% CI: 1.29–1.45, p < 0.0001) and incurred greater 90-day costs of care ($20,143 vs. $16,905, p < 0.0001). The results of the study demonstrate that PD is an independent risk factor for medical complications, implant-related complications, readmission rates, and increased costs of care following a primary THA. The findings of this study should be used in risk stratification and should inform physician–patient discussion but should not be arbitrarily used to deny access to care.

Keywords

total hip arthroplasty - osteoarthritis - current procedural terminology - Parkinson's disease


Publication History

Received: 04 February 2020

Accepted: 10 June 2020

Article published online:
22 September 2020

© 2020. Thieme. All rights reserved.

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