Multi-state models and arthroplasty histories after unilateral total hip arthroplasties.
Summary of "Multi-state models and arthroplasty histories after unilateral total hip arthroplasties."
Background and purpose An increasing number of patients have several joint replacement procedures during their lifetime. We investigated the use and suitability of multi-state model techniques in providing a more comprehensive analysis and description of complex arthroplasty histories held in arthroplasty registries than are allowed for with traditional survival methods. Patients and methods We obtained data from the Australian Orthopaedic Association National Joint Replacement Registry on patients (n = 84,759) who had undergone a total hip arthroplasty for osteoarthritis in the period 2002-2008. We set up a multi-state model where patients were followed from their first recorded arthroplasty to several possible states: revision of first arthroplasty, either a hip or knee as second arthroplasty, revision of the second arthroplasty, and death. The Summary Notation for Arthroplasty Histories (SNAH) was developed in order to help to manage and analyze this type of data. Results At the end of the study period, 12% of the 84,759 patients had received a second hip, 3 times as many as had received a knee. The estimated probabilities of having received a second arthroplasty decreased with age. Males had a lower transition rate for receiving a second arthroplasty, but a higher mortality rate. Interpretation Multi-state models in combination with SNAH codes are well suited to the management and analysis of arthroplasty registry data on patients who experience multiple joint procedures over time. We found differences in the progression of joint replacement procedures after the initial total hip arthroplasty regarding type of joint, age, and sex.
Affiliation
School of Population Health and Clinical Practice.
Journal Details
This article was published in the following journal.
Name: Acta orthopaedica
ISSN: 1745-3682
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22553904
- DOI: http://dx.doi.org/10.3109/17453674.2012.684140
Medical and Biotech [MESH] Definitions
Arthroplasty, Replacement
Partial or total replacement of a joint.
Arthroplasty, Replacement, Finger
Partial or total replacement of one or more FINGERS, or a FINGER JOINT.
Models, Biological
Theoretical representations that simulate the behavior or activity of biological processes or diseases. For disease models in living animals, DISEASE MODELS, ANIMAL is available. Biological models include the use of mathematical equations, computers, and other electronic equipment.
Linear Models
Statistical models in which the value of a parameter for a given value of a factor is assumed to be equal to a + bx, where a and b are constants. The models predict a linear regression.
Models, Economic
Statistical models of the production, distribution, and consumption of goods and services, as well as of financial considerations. For the application of statistics to the testing and quantifying of economic theories MODELS, ECONOMETRIC is available.
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