Perioperative medicine & outcomes
Inpatient Cost of Complications after Total Hip and Knee Arthroplasty
Authors' conclusion
In this large national cohort, perioperative complications substantially increased hospital costs, largely via prolonged LOS. Although sepsis, stroke, and myocardial infarction were most expensive per case, the overall healthcare burden was driven by frequent complications and resource use, including intensive care unit admission, acute renal failure, pulmonary complications, mechanical ventilation, and concurrent complications.
Study context
- Population
- THA/TKA patients in the Premier Healthcare claims database (2006 to 2022)
- Participants
- 2,361,402 patients
- Exposure
- Major postoperative complications vs no complications
- Outcome
- Total cost of hospital stay
Methodological detailsclaims database, generalized estimating equation models
- Claims database
- Generalized estimating equation models
Main finding
As reported in the abstract
Adjusted percent change
+136%
Three or more complications
Adjusted percent change
+88%
Sepsis
Adjusted percent change
+73%
MI
No complications
$16,802
median · IQR $13,731 to $20,838
Three or more complications
$35,477
median · IQR $26,078 to $52,071
Sepsis
$30,633
median · IQR $21,748 to $44,530
MI
$28,908
median · IQR $21,805 to $38,744
Observational data: associations, not effects.
Further findings
- Total cost of hospital stay, THA without complications — No complications
- median $17,250 (IQR $14,072 to $21,355)
Frequent complications as drivers of overall costs
- Renal failure
- +26%
- Pulmonary complications
- +23%
- ICU admission
- +61%
Length of stay (LOS)
- LOS accounted for a substantial share of additional costs
Original publication
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