Today’s Top Story

Study: Model Predicts Readmission After Lumbar Fusion

In a retrospective, case-control study published online in the European Spine Journal, researchers developed a predictive model for 30-day readmission rates in elective level 1–2 posterior lumbar spine fusion (PSF) patients. PSF patients were randomized to either a derivation or validation cohort. A readmission after posterior spinal fusion (RAPSF) score was created using the following variables: age, female sex, race, insurance, anterior approach, cerebrovascular disease, chronic pulmonary disease, congestive heart failure, diabetes, hemiplegia/paraplegia, rheumatic disease, drug abuse, electrolyte disorder, osteoporosis, depression, obesity, and morbid obesity. The derivation cohort had 92,262 patients, and the validation cohort had 90,257 patients. Thirty-day readmission rates were 10.9 percent and 11.1 percent, respectively. The RAPSF score accurately predicted 30-day readmission rates.

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Other News

Study Finds Increased Mortality Risk in Older Nonoperative Hip Fracture Patients

Hip fracture patients aged ≥ 65 years may have better survival outcomes with operative treatment versus nonoperative fracture management, according to a retrospective cohort study published in the Feb. 26 issue of the Journal of Orthopaedic Trauma. A total of 231 patients with either femoral neck or intertrochanteric fracture were included in the study; 154 underwent surgery, while 77 received nonoperative treatment. In-hospital, 30-day, and one-year mortality rates were significantly higher in the nonoperative cohort compared to the surgical cohort, and mean life expectancy was significantly shorter among nonoperative patients (221 days versus 1,024 days).

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Study Measures Safety of Outpatient Unicompartmental Knee Arthroplasty

A study published online in The Knee found that unicompartmental knee arthroplasty (UKA) in the outpatient versus inpatient setting may be safe and associated with positive outcomes. Researchers retrospectively evaluated data from 2,600 outpatient UKA and 5,084 inpatient UKA patients who underwent surgery between 2007 and 2016. During the study period, outpatient UKA surgeries increased from 14.5 percent to 58.1 percent. When adjusting for confounding factors, outpatient procedure was associated with decreased postoperative transfusion and pneumonia risks, and a trend was observed toward decreased 90-day readmission risk.

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Study: Scoring Assessment Determines Fracture Risk in Diabetes Patients

In a cross-sectional study published in the May issue of Bone, researchers developed a tool that could estimate vertebral fracture risk in patients with type 2 diabetes. A total of 808 patients were included in the study. Researchers used logistic regression analysis to identify variables associated with vertebral fracture; these variables were stratified by cutoff values calculated using receiver operating characteristic curves. Each factor was given a relative weight and assigned a tentative score; the score’s cutoff point was used to predict vertebral fracture. After logistic regression analysis, the following factors were associated with vertebral fracture risk: age, diabetes duration, body mass index, serum albumin, and T score at femoral neck.

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CMS Releases Open Enrollment Report

The Centers for Medicare & Medicaid Services (CMS) issued its “Health Insurance Exchanges 2019 Open Enrollment Report.” Plan selections in the exchange across all 50 states plus Washington, D.C., was at 114 million—an estimated decrease in plan selections of 300,000 from a year ago. The average total premiums for plans chosen through HealthCaregov decreased for the first time since the exchange began operation five years ago, going down by 1.5 percent.

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FDA Issues Stem Cell Treatment Warning, Signals Increased Enforcement

In December 2018, the Food and Drug Administration (FDA) sent a warning letter to Genetech Inc., after a facility inspection turned up numerous deviations from current good manufacturing and tissue practices. The letter followed a voluntary recall of some of the company’s products due to adverse effects. The FDA intends to exercise enforcement discretion for certain products until November 2020, but for products that pose potential safety concerns for patients, the agency will employ the risk-based approach to enforcement outlined in its comprehensive regenerative medicine policy framework. Surgeons must be familiar with the regulatory status of therapies they offer, especially in the rapidly changing regulatory environment for regenerative medicine products.

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Final Call: Apply for the MACRA Episode-based Cost Measures Clinical Subcommittees Member Position

AAOS is seeking to nominate members to the MACRA Episode-based Cost Measures Clinical Subcommittee. CMS has contracted with Acumen, LLC, to develop care episode and patient condition groups for use in cost measures to meet the requirements of the Medicare Access and CHIP Reauthorization Act. The clinical subcommittee is a large body of clinicians that will meet during the last week of May to select which episode-based cost measure to develop, discuss the measure intent, and provide input on the desired composition of the workgroup that will build out the selected measure. The application deadline is April 9.

Learn more and submit your application…(member login required)


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