Patient "No-Show" Prior to Elective Primary Total Hip Arthroplasty Increases Risk of Postoperative Anemia

Overview

Journal Arthroplast Today

Publisher Elsevier

Date 2025 Jan 24

PMID 39850465

Authors

Jeffrey S Mun

Matthew W Parry

Alex Tang

Jesse J Manikowski

Cory Crinella

John J Mercuri

Affiliations

Soon will be listed here.

Abstract

Background: Patients who "no-show" (NS) clinical appointments are at a higher risk of poor healthcare outcomes. The objective of this study was to evaluate and characterize the relationship between patient NS prior to primary total hip arthroplasty (THA) and 90-day complication risk after THA.

Methods: We retrospectively reviewed 4147 patients undergoing primary THA. Patients were divided based on whether they NS at least 1 appointment vs always attend (AA) appointments. Information collected included number of NS and attended appointments, demographics, comorbidities, and 90-day postoperative complications. Regression analyses were run to identify relationships between NS status and postoperative outcomes, as well as factors that would predict NS status.

Results: Compared to AA patients, NS patients had an increased odds of a postoperative complication (odds ratio:1.3, = .0005), specifically postoperative anemia (odds ratio: 1.3, = .0004). When comparing NS and AA patients who both experienced postoperative anemia-related complications, the NS patients had significantly greater intraoperative blood loss compared to AA patients (mean ± standard deviation: 412.6 mL ± 310.2 vs 357.3 mL ± 269.0, = .028). NS patients also had a greater rate of symptomatic anemia compared to AA patients (100 [3%] vs 25 cases [2%], = .018). Age, smoking status, gender, race, body mass index, Charlson Comorbidity Index, and insurance status were independent predictors of missing clinical appointments.

Conclusions: There was an increased risk for complications, specifically anemia-related complications, in THA patients who NS preoperatively. Demographic factors were independently associated with higher odds of missing a scheduled clinical appointment. The results suggest orthopedic surgeons should consider NS data to pre-emptively assess risk for complications following THA.

Level Of Evidence: Level III.

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