Background/Purpose: Given the absence of national longitudinal data on patients who undergo total joint arthroplasty (TJA) and the limitations of hospital databases to capture information on patients who seek post-TJA care elsewhere, there is growing interest in using patient self-report to identify complications following surgery. We examined the concordance between patients self-report of potential short-term complications with review of available medical records.
Methods: Patients undergoing primary hip or knee arthroplasty from 7/1/11 through 12/3/12 participating in a tertiary care center were identified. Patients completed a 6-month post-operative survey regarding evaluation at an emergency department, day surgery or hospitalization for possible medical or mechanical complications following primary TKA/THA. We reviewed available inpatient and outpatient medical records and examined the sensitivity, specificity, positive predictive values and negative predictive values for patient-self report and medical records.
Results: There were 328 patients who had 339 surgeries and completed the 6-month questionnaire. Patients reported 46 medical encounters (emergency department, day surgery or inpatient care): 15 were excluded as they were hospitalizations >90 days following surgery or unlikely to be related to TJA (e.g., tooth extraction) resulting in a 10% possible event rate; 12% of the events occurred at hospitals different from the surgical hospital. Review of medical records revealed 6 additional medical encounters that patients had not mentioned including 3 hospitalizations following surgery (2 for leg pain and 1 for cellulitis) and 3 emergency department visits where no complications from TJA were identified. Patient self-report of emergency department, day surgery and inpatient care for possible complications was both sensitive (91%) and specific (100%). The positive predictive value was 100% and negative predictive value 99%.
Conclusion: We examined the concordance between patients’ self-report of possible complications following surgery with review of available medical records and found a sensitivity of 91% and positive predictive value of 100% suggesting this approach may be used to augment current hospital post-discharge surveillance procedures. Patients appropriately reported medical care signifying potential adverse events following TJA. Given the new public reporting requirements of all post-TJA discharge complications, patient reported post-operative events may augment current hospital-specific surveillance procedures.
Disclosure:
L. R. Harrold,
CORRONA, Inc.,
5;
D. Ayers,
AHRQ, Zimmer,
2;
R. O’Keefe,
None;
C. Lewis,
None;
V. Pellegrini,
None;
P. D. Franklin,
NIAMS-NIH, NLM-NIH, AHRQ, Zimmer, ,
2.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-validity-of-patient-reported-short-term-complications-following-total-hip-and-knee-arthroplast/