One in seven joint replacement patients readmitted to hospital within a year



    Special study shows post-surgical complications most likely causes of
    hospitalization

    OTTAWA, March 26 /CNW Telbec/ - One out of every seven patients who
undergoes a knee or elective hip replacement procedure returns to the hospital
within one year, in some cases because of complications related to their
surgery. Today, the Canadian Institute for Health Information (CIHI) releases
two publications, the annual Canadian Joint Replacement Registry report and a
special study, Hospitalizations, Early Revisions and Infections Following
Joint Replacements. According to the special study, 51,029 people underwent a
first-time knee or elective hip replacement (outside of Quebec) in 2005-2006.
Of these patients, more than 7,700 were hospitalized at least once in the
subsequent 12 months. Compared to hospital use by the same group of patients
in the year before surgery, this represents an increase of more than
2,000 patients hospitalized and an extra 44,000 hospital days.
    "While joint replacement surgery can certainly improve the quality of a
patient's life, it is not always without complications," says Tracy Johnson,
Project Consultant at CIHI. "Investigating the reasons for these extra
hospitalizations can offer opportunities to improve quality, reduce costs and
improve both hospital and surgeon availability for other patients who need
care."

    Infections and early revisions among the most serious post-surgery
    hospitalizations

    The most common reason people are admitted to hospital after undergoing
either an elective (non-emergency) hip replacement or a knee replacement is
complications directly associated with the surgery, such as loosening of the
prosthesis, dislocation or infection. These accounted for 18% of the
hospitalizations in the year following joint replacement surgery.
    Patients hospitalized for infection spent on average twice as long in
hospital when compared with those admitted for other reasons following
surgery. Men were more likely than women to have a post-surgical
hospitalization for infection, and patients with diabetes had a higher rate of
infection than those without. Just more than 1% of patients were hospitalized
for a revision surgery (meaning the new joint is removed and replaced) within
one year. Elective hip patients were more likely to require this second
surgery than knee replacement patients.
    Both hip and knee replacement patients were more likely to be
hospitalized in the year following their surgery than in the year before,
though the change was greater for knee replacement patients. While hospital
admissions for those who underwent knee replacements increased by 52% in the
year following their surgery, they increased by only 15% for elective hip
replacement patients.

    Additional hospital stays estimated to cost $45 million

    When the study looked at both knee and elective hip replacement patients,
it found this group spent 44,000 more days in hospital in the year after
surgery than in the year before. The increase was due to the overall rise in
hospitalizations and because these patients tend to stay longer in the
hospital. The costs associated with additional hospitalizations in the year
after elective joint replacement surgery are estimated to be $45 million in
Canada (outside Quebec).

    Additional highlights from Hip and Knee Replacements in Canada

    
    - In 2004, Canada's first ministers identified joint replacement as a
      priority for wait time reduction. In 2005-2006, the first fiscal year
      following the agreement, hip and knee replacements grew by 17% when
      adjusted for age and other demographic changes in the population.

    - In 2005-2006 there were 68,746 hospitalizations for hip (28,045) and
      knee (40,701) replacements performed in Canada (including primary and
      revision procedures), representing a 10-year increase in the number of
      procedures performed of 100%.

    - The majority (63%) of Canadians receiving a joint replacement in 2005-
      2006 were 65 years of age or older.

    - The rates of hip and knee replacements among 45 to 54 year olds have
      risen considerably in the last decade. The rate of knee replacements
      has tripled for males and more than tripled for females, while the rate
      of hip replacements has increased by 68% for men and 52% for women over
      the same time period.

    - The most notable increase was seen in knee replacements for women aged
      55 to 64; in 2005-2006, there were 6,217 knee replacements performed on
      females in this age group, which was a 229% increase from the
      1,892 performed 10 years before, in 1995-1996.

    About CIHI

    The Canadian Institute for Health Information (CIHI) collects and analyzes
information on health and health care in Canada and makes it publicly
available. Canada's federal, provincial and territorial governments created
CIHI as a not-for-profit, independent organization dedicated to forging a
common approach to Canadian health information. CIHI's goal: to provide
timely, accurate and comparable information. CIHI's data and reports inform
health policies, support the effective delivery of health services and raise
awareness among Canadians of the factors that contribute to good health.

    The report and the following figure and tables are available from CIHI's
    website, at www.cihi.ca.

    Table 1.  Comparison of Hospitalization Patterns Before and After Surgery
              for Elective Primary Hip and Knee Replacements in 2005-2006
              (adapted from Table 1 in the special study)

    Table 2.  Patients Hospitalized Before and After Elective Joint
              Replacement (Table 4 in the special study)

    Figure 1. Number of Hospitalizations for Hip and Knee Replacement
              Procedures in Canada, 1995-1996 to 2005-2006 (Figure 4 in CJRR
              Report)
    




For further information:

For further information: Leona Hollingsworth, (613) 241-7860 ext. 4140,
Cell: (613) 612-3914, lhollingsworth@cihi.ca; Jennie Hoekstra, (613) 241-7860
ext. 4331, jhoekstra@cihi.ca


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