1054. Race/Ethnicity and Mortality/Complication Rates After Knee/Hip Replacement
Said A Ibrahim, MD, MPH, Center for Health Equity Research and Promotion, VA Pittsburgh, R Stone, Center for Health Equity Research and Promotion, VA Pittsburgh, ME Kelley, Center for Health Equity Research and Promotion, VA Pittsburgh, XS Han, Center for Health Equity Research and Promotion, VA Pittsburg, W Henderson, VA National Surgical Quality Improvement Program, VA Denver, S Kuri, VA National Surgical Quality Improvement Program, VA Boston, CK Kwoh, Center for Health Equity Research and Promotion, VA Pittsburgh, MJ Fine, Center for Health Equity Research and Promotion, VA Pittsburgh

Objectives: African-American (AA) patients express worse outcome expectations from joint replacement compared to whites. We examined racial/ethnic differences in 30-day mortality and complication rates following an elective knee or hip replacement.

Methods: The sample consisted of patients in the VA National Surgical Quality Improvement Program database who underwent elective knee (n=12,108) or hip replacements (n=7,703) during a 5-year period (1996-2000). We conducted separate logistic regression models to predict any complication from knee or hip replacement, with hospital as a random effect. We adjusted for predictors of surgical risk.

Results: The overall 30-day mortality rate following knee replacement was 0.6%, and did not differ significantly by race/ethnicity (P= 0.4). The overall complication rate was 6.7 %. Among patients without COPD, relative to whites, the adjusted odds ratio of complications was 1.26 (95% CI: 0.98-1.63) for AAs and 1.24 (95% CI: 0.84-1.85) for Hispanics. Among patients with COPD, relative to whites, the adjusted odds ratio of complications was 1.94 (95% CI: 1.02-3.73) for AAs and 4.30 (95% CI: 2.00-3.73) for Hispanics. The overall 30-day mortality rate following hip replacement was 0.7%, and did not differ significantly by race/ethnicity (P= 0.8). Overall complication rate was 8.6%, and did not differ by race/ethnicity (P= 0.9). Relative to whites, the adjusted odds ratio of complications for AAs was 1.13 (95% CI: 0.87-1.46) and 1.20 (95% CI: 0.73-1.97) for Hispanics.

Conclusions: Excluding patients with COPD, there are no racial/ethnic differences in 30-day mortality or complications.

Impact: Managing co-existing COPD may improve surgical outcomes for racial/ethnic minorities undergoing knee replacement.