Show simple item record

dc.contributor.authorSilman, Alan
dc.contributor.authorCombescure, Christophe
dc.contributor.authorFerguson, Rory J
dc.contributor.authorGraves, Stephen E.
dc.contributor.authorPaxton, Elizabeth W
dc.contributor.authorFrampton, Chris
dc.contributor.authorFurnes, Ove Nord
dc.contributor.authorFenstad, Anne Marie
dc.contributor.authorHooper, Gary
dc.contributor.authorGarland, Anne
dc.contributor.authorSpekenbrink-Spooren, Anneke
dc.contributor.authorWilkinson, J. Mark
dc.contributor.authorMäkelä, Keijo
dc.contributor.authorLübbeke, Anne
dc.contributor.authorRolfson, Ola
dc.description.abstractBackground and purpose — A challenge comparing outcomes from total hip arthroplasty between countries is variation in preoperative characteristics, particularly comorbidity. Therefore, we investigated between-country variation in comorbidity in patients based on ASA class distribution, and determined any variation of ASA class to mortality risk between countries. Patients and methods — All arthroplasty registries collecting ASA class and mortality data in patients with elective primary THAs performed 2012–2016 were identified. Survival analyses of the influence of ASA class on 1-year mortality were performed by individual registries, followed by meta-analysis of aggregated data. Results — 6 national registries and 1 US healthcare organization registry with 418,916 THAs were included. There was substantial variation in the proportion of ASA class III/IV, ranging from 14% in the Netherlands to 39% in Finland. Overall, 1-year mortality was 0.93% (95% CI 0.87–1.01) and increased from 0.2% in ASA class I to 8.9% in class IV. The association between ASA class and mortality measured by hazard ratios (HR) was strong in all registries even after adjustment for age and sex, which reduced them by half in all registries. Combined adjusted HRs were 2.0, 6.1, and 22 for ASA class II–IV vs. I, respectively. Associations were moderately heterogeneous across registries. Interpretation — We observed large variation in ASA class distribution between registries, possibly explained by differences in background morbidity and/or international variation in access to surgery. The similar, strong mortality trends by ASA class between countries enhance the relevance of its use as an indicator of comorbidity in international registry studies.en_US
dc.publisherTaylor and Francisen_US
dc.rightsNavngivelse 4.0 Internasjonal*
dc.titleInternational variation in distribution of ASA class in patients undergoing total hip arthroplasty and its influence on mortality: data from an international consortium of arthroplasty registriesen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.rights.holderCopyright 2021 The Author(s)en_US
dc.source.journalActa Orthopaedicaen_US
dc.identifier.citationActa Orthopaedica. 2021, 92 (3), 304-310.en_US

Files in this item


This item appears in the following Collection(s)

Show simple item record

Navngivelse 4.0 Internasjonal
Except where otherwise noted, this item's license is described as Navngivelse 4.0 Internasjonal