Patient injuries in primary total hip replacement Nationwide analysis in Finland

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http://hdl.handle.net/10138/164643

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Helkamaa , T , Hirvensalo , E , Huhtala , H & Remes , V 2016 , ' Patient injuries in primary total hip replacement Nationwide analysis in Finland ' Acta Orthopaedica , vol. 87 , no. 3 , pp. 209-217 . DOI: 10.3109/17453674.2015.1135662

Title: Patient injuries in primary total hip replacement Nationwide analysis in Finland
Author: Helkamaa, Teemu; Hirvensalo, Eero; Huhtala, Heini; Remes, Ville
Contributor: University of Helsinki, Dep. of Pharmacology and Toxicology (Inst. of Biomedicine) (-2009)
University of Helsinki, I kirurgian klinikka (Töölö)
Date: 2016-06
Language: eng
Number of pages: 9
Belongs to series: Acta Orthopaedica
ISSN: 1745-3674
URI: http://hdl.handle.net/10138/164643
Abstract: Background and purpose - Although the results of primary total hip replacements (THRs) are generally excellent, sometimes serious complications arise. Some of these severe complications are considered to be patient injuries. We analyzed primary THR-related patient injuries in a nationwide setting. Patients and methods - We evaluated all the primary THR-related patient injury claims in Finland between 2008 and 2010. We used the original medical records and 2 nationwide registries, the Care Register for Social Welfare and Health Care and the Patient Injury Claim Register. Results - We identified 563 claims, 44% of which were compensated (n = 250). Of these 250 compensated claims, 79% were considered to be avoidable (treatment injuries) and 21% were severe unexpected infections (with a preoperative infection risk of less than 2%). The most common type of technical error was cup malposition (31%). High-volume hospitals (with an annual primary THR volume >= 400) had a lower patient injury rate. In lower-volume hospitals (with an annual primary THR volume of <400), the relative risks (RRs) of patient injury for any reason, due to technical errors, or because of cup malposition were 2-fold (95% CI: 1.6-3.1), 4-fold (95% CI: 2.3-6.2), and 9-fold (95% CI: 3-28), respectively, compared to high-volume hospitals. Interpretation - Our study provides the first comprehensive nationwide data on THR-related patient injury types. Hospital volume was associated with the quality and quantity of errors detected. An annual hospital volume of >= 400 primary THRs was established as a protective factor against patient injuries.
Subject: POSTOPERATIVE COMPLICATIONS
CLAIMING BEHAVIOR
SURGICAL VOLUME
ARTHROPLASTY
RATES
DISLOCATION
MORTALITY
SURGEON
CUSUM
RISK
3126 Surgery, anesthesiology, intensive care, radiology
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