Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Online First™

Articles

Perioperative Risk Adjustment for Total Shoulder Arthroplasty: Are Simple Clinically Driven Models Sufficient?

David N. Bernstein MA, Aakash Keswani BA, David Ring MD, PhD
30th November 2016, Symposium: Learning From Large-Scale Orthopaedic Databases

There is growing interest in value-based health care in the United States. Statistical analysis of large databases can inform us of the factors associated with and the probability of adverse events and unplanned readmissions that diminish quality and add expense. For example, increased operating time and high blood urea nitrogen (BUN) are associated with adverse events, whereas patients on antihypertensive medications were more likely to have an unplanned readmission. Many surgeons rely on their knowledge and intuition when assessing the risk of a procedure. Comparing clinically driven with statistically derived risk models of total shoulder arthroplasty (TSA) offers insight into potential gaps between common practice and evidence-based medicine.

Results of Database Studies in Spine Surgery Can Be Influenced by Missing Data

Bryce A. Basques MD, Ryan P. McLynn BS, Michael P. Fice BS, Andre M. Samuel MD, Adam M. Lukasiewicz MD, MSc, Daniel D. Bohl MD, MPH, Junyoung Ahn MD, Kern Singh MD, Jonathan N. Grauer MD
28th November 2016, Symposium: Learning From Large-Scale Orthopaedic Databases

National databases are increasingly being used for research in spine surgery; however, one limitation of such databases that has received sparse mention is the frequency of missing data. Studies using these databases often do not emphasize the percentage of missing data for each variable used and do not specify how patients with missing data are incorporated into analyses. This study uses the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to examine whether different treatments of missing data can influence the results of spine studies.