Dermatomyositis and polymyositis in total hip arthroplasty

作     者：Samuel Rosas Michael Schallmo Anirudh Krishna Gowd Matthew Reynolds Akelman T David Luo Cynthia Lynn Emory Johannes Frank Plate 

作者机构：Department of Orthopedic SurgeryWake Forest School of MedicineWinston SalemNC 27101United States Department of Orthopedic SurgeryAtrium HealthcareCharlotteNC 28203United States 

出 版 物：《World Journal of Orthopedics》 (世界骨科杂志（英文版）)

年 卷 期：2021年第12卷第6期

页      面：395-402页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Dermatomyositis Arthroplasty Polymyositis Outcomes Charges Reimbursement 

摘      要：BACKGROUND Idiopathic inflammatory myopathies(IIM)are systemic autoimmune disorders such as dermatomyositis(DM),polymyositis(PM),inclusion body myopathy,and autoimmune necrotizing myopathy that,similar to osteoarthritis,affect quality of life and activities of daily ***,these patients are often burdened with chronic pain and disability;however,the outcomes and risk of total hip arthroplasty(THA)in this patient population remain *** To evaluate 90-d complications and costs in patients with these *** A retrospective case control study was designed by accessing data from the Medicare dataset available on the PearlDiver *** with IIM,here,those with DM and PM were matched based on possible confounding variables to a cohort without these diseases and with the same 10-year risk of mortality as defined by the Charlson Comorbidity Index Score(CCI).Univariate and multivariate analysis were performed to evaluate complications and t-tests to evaluate 90-d Medicare reimbursements as markers of costs after *** The total sample was 1090 patients with each cohort comprised of *** were 74.9%of the *** mean CCI was 5.89(SD 2.11).Those with IIM had increased rates of pneumonia[odds ratio(OR)1.45,P0.001]and pulmonary embolism(OR 1.46,P=0.035)and decreased hematoma risks(OR 0.58,P=0.00).90-d costs were on average$1411 greater for those with IIM yet not significantly different(P=0.034).CONCLUSION Patients with IIM have an increased 90-d rate of pneumonia and pulmonary embolism concomitant with a decreased hematoma rate consistent with their procoagulatory *** attention to increased resource utilization in these patients is also warranted.