التفاصيل البيبلوغرافية
| العنوان: |
Non-compliance with clinical guidelines increases the risk of complications after primary total hip and knee joint replacement surgery |
| المؤلفون: |
Helen Mary Badge, Tim Churches, Justine M. Naylor, Wei Xuan, Elizabeth Armstrong, Leeanne Gray, John Fletcher, Iain Gosbell, Christine Lin, Ian A. Harris |
| المصدر: |
PLoS ONE, Vol 16, Iss 11 (2021) |
| بيانات النشر: |
Public Library of Science (PLoS) |
| سنة النشر: |
2021 |
| المجموعة: |
Directory of Open Access Journals: DOAJ Articles |
| مصطلحات موضوعية: |
Medicine, Science |
| الوصف: |
Background Total hip and total knee replacement (THR/TKR) are common and effective surgeries to reduce the pain and disability associated with arthritis but are associated with small but significant risks of preventable complications such as surgical site infection (SSI) and venous-thrombo-embolism (VTE). This study aims to determine the degree to which hospital care was compliant with clinical guidelines for the prevention of SSI and VTE after THR/TKR; and whether non-compliant prophylaxis is associated with increased risk of complications. Methods and findings A prospective multi-centre cohort study was undertaken in consenting adults with osteoarthritis undergoing elective primary TKR/THR at one of 19 high-volume Australian public or private hospitals. Data were collected prior to surgery and for one-year post-surgery. Four adjusted logistic regression analyses were undertaken to explore associations between binary non-compliance and the risk of surgical complications: (1) composite (simultaneous) non-compliance with both (VTE and antibiotic) guidelines and composite complications [all-cause mortality, VTE, readmission/reoperation for joint-related reasons (one-year) and non-joint-related reasons (35-days)], (2) VTE non-compliance and VTE outcomes, (3) antibiotic non-compliance and any SSI, and (4) antibiotic non-compliance and deep SSI. Data were analysed for 1875 participants. Guideline non-compliance rates were high: 65% (VTE), 87% (antibiotics) and 95% (composite guideline). Composite non-compliance was not associated with composite complication (12.8% vs 8.3%, adjusted odds ratio [AOR] = 1.41, 95%CI 0.68–3.45, p = 0.40). Non-compliance with VTE guidelines was associated with VTE outcomes (5% vs 2.4%, AOR = 2.83, 95%CI 1.59–5.28,p < 0.001). Non-compliance with antibiotic guidelines was associated with any SSI (14.8% vs 6.1%, AOR = 1.98, 95%CI 1.17–3.62,p = 0.02) but not deep infection (3.7% vs 1.2%,AOR = 2.39, 95%CI 0.85–10.00, p = 0.15). Conclusions We found high rates of clinical variation and ... |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| تدمد: |
1932-6203 |
| العلاقة: |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8601457/?tool=EBITest; https://doaj.org/toc/1932-6203Test; https://doaj.org/article/0cd9504c40644c1d80b4226e7405ea8fTest |
| الإتاحة: |
https://doaj.org/article/0cd9504c40644c1d80b4226e7405ea8fTest |
| رقم الانضمام: |
edsbas.ECC283D |
| قاعدة البيانات: |
BASE |
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