Today’s Top Story

Study: Does Prior ED Admission Predict 90-day Readmission in TJA?

Total joint arthroplasty (TJA) patients who presented to the emergency department (ED) within one year preoperatively had higher rates of 90-day readmission, according to a retrospective study published online in The Journal of Arthroplasty. A total of 6,996 elective TJA patients (2,453 total hip arthroplasty [THA], 4,543 total knee arthroplasty [TKA]) were included in the study. THA patients with one preoperative ED visit had a 2.0 odds ratio (OR) of returning to the ED postoperatively; in TKA patients, the OR was 1.9. Increasing ED visit frequency was associated with greater ORs for a return trip after TJA.

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Other News

Study Evaluates Long-term Outcomes for Older Patients Transported by EMS

The two most common causes of death among older patients who require emergency medical service (EMS) transport were cardiovascular comorbidities and dementia, according to a cohort study published online in Injury. In 2011, 15,649 injured adults aged ≥ 65 years were transported to 51 hospitals by 44 EMS agencies, of whom 3.5 percent had a serious injury (defined as an Injury Severity Score ≥ 16). The most common serious injury was an extremity injury (17.8 percent). About a fifth (20.3 percent) of patients died within one year, 9.4 percent within 90 days, 5.1 percent within 30 days, and 1.6 percent in the hospital. More than half (53.3 percent) of patients died due to cardiovascular causes, and 32.7 percent died from causes related to dementia; 12.8 percent of death certificates listed injury as the cause of death.

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Study Measures Improvements in Comorbidities Coding

A study published online in Injury found that new coding rules implemented in Australian hospitals led to improvements in capturing patient comorbidity data. The Victorian Orthopaedic Trauma Outcomes Registry was queried for a sample of 400 orthopaedic trauma patients aged > 15 years. Researchers compared diagnoses of obesity, arthritis, diabetes, and cardiac conditions documented within patients’ medical records to International Statistical Classification of Diseases, 10th Revision, Australian Modification comorbidity codes. They used Cohen’s kappa to measure how the two compared before and after the new coding rules went into effect. Agreement ranged from poor for coronary artery disease to excellent for type 2 diabetes; for most conditions, the new coding rules improved agreement rates.

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Study Determines High-risk Fracture Sites in Benign Prostatic Hyperplasia Patients

A retrospective study published in the May issue of Osteoporosis International compared the risks of spine, hip, and wrist fracture in patients with benign prostatic hyperplasia. Healthy controls were matched 4:1 to 48,114 patients with benign prostatic hyperplasia whose data were obtained from the National Health Insurance Research Database of Taiwan. Compared to the control cohort, benign prostatic hyperplasia patients had a significantly greater risk of new vertebral compression fractures in the thoracic spine and lumbar spine, as well as hip fracture but not wrist fracture.

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AMA Says Physicians are More Often Employees than Owners

According to data from the American Medical Association’s (AMA) Physician Practice Benchmark Surveys, 2018 was the first year where there were more physician employees (47.4 percent) than those who owned a share of their practice (45.9 percent). Owners were more likely to be older and male. The age gap was significant: among physicians younger than 40 years, 25.5 percent were owners compared to 54.3 percent of physicians aged 55 years and older.

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Stay Calm! Tips for Managing Hemorrhage in the Operating Room

In part two of a two-part series, Kevin A. Raskin, MD, shared tips and pearls for managing hemorrhage. During the AAOS 2019 Annual Meeting, he said the most important message in bleeding events is, “Slow down. Pack and wait. You can handle this.”

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Apply for the Governance Committee Positions

The Governance Committee has open positions for a chair and four members. The Governance Committee will assist, support, and advise the Board of Directors in exercising its oversight of governance obligations and in the related development and implementation of governance documents, structures, and procedures. The application deadline is May 24.

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


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