Parkinson's Disease Is Associated with Increased Complications, Readmission Rates, and Costs of Care after Total Hip Arthroplasty: A Matched-Cohort Analysis

Abstract

AbstractStudies investigating the impact of Parkinson's disease (PD) on patients undergoing primary total hip arthroplasty (THA) are limited. Therefore, the purpose of this study was to investigate whether PD patients undergoing primary THA are at increased risk of: (1) medical complications; (2) implant-related complications; (3) readmissions; and (4) costs. A query was performed using an administrative claims database. Matched non-PD patients undergoing primary THA served as a control group. Non-PD patients undergoing primary THA served as a matching cohort. The query yielded 39,184 patients (PD = 9,796; control = 29,388). Pearson's chi-square tests, logistic regression analyses, and Welch's t-tests were used to test for significance between the cohorts. Patients who have PD were found to have increased odds (4.64 vs. 1.15%; odds ratio [OR]: 4.19, 95% confidence interval [CI]: 3.60–4.87, p < 0.0001) of medical complications compared with the matched cohort. PD patients had greater odds of implant-related complications (7.12 vs. 3.99; OR: 1.84, p < 0.0001). PD patients also had significantly higher odds of 90-day readmission (19.83 vs. 15.29%; OR: 1.37, 95% CI: 1.29–1.45, p < 0.0001) and incurred greater 90-day costs of care ($20,143 vs. $16,905, p < 0.0001). The results of the study demonstrate that PD is an independent risk factor for medical complications, implant-related complications, readmission rates, and increased costs of care following a primary THA. The findings of this study should be used in risk stratification and should inform physician–patient discussion but should not be arbitrarily used to deny access to care.