Hip Replacements Have Fewer Complications in High Volume Centers

Mortality and complication rates of total hip replacements decrease as hospitals' and surgeons' procedure volume increases, according to research presented at the American College of Rheumatology Annual Scientific Meeting Nov. 13--17 in Boston, Mass.

The researchers analyzed Medicare claims for 70,000 primary and revision total hip replacements performed from July 1995 to June 1996. They found that the mortality rate was two and a half times as high in the low volume hospitals (fewer than six such surgeries per year in Medicare patients) than in high volume hospitals (more than 100 such surgeries per year in Medicare patients). The dislocation rate was also two and half times as high in low volume hospitals. The infection rate was four times as high.

"Our findings are consistent with research showing better outcomes in high volume centers following cardiac procedures," said lead investigator Jeffrey Katz, MD, of Brigham and Women's Hospital in Boston, Mass. "We are investigating whether the outcomes following hip replacement are due to differences in characteristics of patients who undergo surgery in small versus large hospitals, or to differences in the type of care provided in these centers."

The American College of Rheumatology is the professional organization for rheumatologists and health professionals who share a dedication to healing, preventing disability and curing arthritis and related rheumatic and musculoskeletal diseases. For more information on the ACR's annual meeting, see http://www.rheumatology.org.

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