Search

Your search keyword '"Graves, Stephen E."' showing total 3 results
Start Over Author "Graves, Stephen E." Search Limiters Full Text Search Limiters Peer Reviewed Publisher springer nature
3 results on '"Graves, Stephen E."'

1. Association between patient factors and hospital completeness of a patient-reported outcome measures program in joint arthroplasty, a cohort study.

Author

Harris, Ian A., Peng, Yi, Cashman, Kara, Ackerman, Ilana, Heath, Emma, Rowden, Neville, and Graves, Stephen E.

Subjects
SURGERY & psychology, AGE distribution, ARTHROPLASTY, PATIENTS, HEALTH outcome assessment, HOSPITAL health promotion programs, REGRESSION analysis, DOCUMENTATION, MEDICAL care research, SEX distribution, DESCRIPTIVE statistics, STATISTICAL sampling, BODY mass index
Abstract

Background: The collection of patient-reported outcome measures (PROMs) following arthroplasty is common. PROMs data collection programs seek to maximise completeness in order to minimise selection bias and optimise representativeness of the sample attained. We aimed to determine if patient factors influence variation in PROMs program completeness between-hospitals. Methods: Using data from a national arthroplasty registry PROMs program, we tested for associations between patient characteristics (age, sex, body mass index [BMI] and American Society of Anaesthesiologists [ASA] class) and both potential completeness (registration completeness: the proportion of arthroplasty patients that were registered in the PROMs electronic system) and actual completeness (response completeness: the proportion of arthroplasty patients who provided PROMs data) using linear regression. Results: When using all elective primary total hip, knee or shoulder arthroplasty procedures (N = 31,801) from 43 hospitals as the denominator, overall registration completeness was 52%, varying from 5 to 87% between hospitals. Overall pre-operative response completeness was 46%, varying from 5 to 82% between hospitals. There were no significant associations between hospital-level registration completeness or response completeness and age, sex, BMI or ASA score. Conclusion: Completeness rates of a PROMs program in arthroplasty varied widely between hospitals but in the absence of a relationship between measured patient factors and completeness rates, the observed variation likely relates to local site factors such as access to patients, local resources and clinician engagement with the program. Efforts to improve the rates of completeness of arthroplasty PROMs programs at individual hospitals may not improve the representativeness of the sample. Plain English summary: Hospitals vary in how completely they include and follow up patients when measuring patient-reported health. It is important to know if the completeness of inclusion and follow up by hospitals is affected by patient characteristics. This study addresses that problem by using data from a national patient outcome survey involving over 30,000 patients from 43 hospitals to look at the correlation between certain patient characteristics (like age, sex, obesity and general health) and the rates of inclusion and follow up for each hospital. Rates of inclusion (registering patients in the program) and follow up rates varied widely between hospitals (from 5 to 87%). The rates of inclusion and follow up were not correlated with patient age, sex, body mass index or their general health. These findings suggest that the variation between hospitals in the rates of inclusion of joint replacement patients in health surveys are not due to differences in patient characteristics. The differences may be due to local hospital factors, such as resources and clinician engagement. [ABSTRACT FROM AUTHOR]

Published
2022
Full Text
View/download PDF

2. Cross-sectional analysis of association between socioeconomic status and utilization of primary total hip joint replacements 2006–7: Australian Orthopaedic Association National Joint Replacement Registry

Author

Margaret J. Henry, Anita E. Wluka, Stephen E. Graves, Mark A. Kotowicz, Julie A. Pasco, Tyman E Stanford, Richard S. Page, Geoffrey C. Nicholson, Sharon L. Brennan, Brennan, Sharon L, Stanford, Tyman, Wluka, Anita E, Henry, Margaret J, Page, Richard S, Graves, Stephen E, Kotowicz, Mark A, Nicholson, Geoffrey C, and Pasco, Julie A

Subjects
Adult, Male, medicine.medical_specialty, lcsh:Diseases of the musculoskeletal system, Sports medicine, Cross-sectional study, Arthroplasty, Replacement, Hip, medicine.medical_treatment, utilization, Social class, Osteoarthritis, Hip, socioeconomic status, Young Adult, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Rheumatology, Hip joint replacement, hip joint replacement, Epidemiology, medicine, Humans, Orthopedics and Sports Medicine, Registries, 030212 general & internal medicine, Socioeconomic status, Societies, Medical, Aged, 030203 arthritis & rheumatology, Rehabilitation, business.industry, Process Assessment, Health Care, Australia, Middle Aged, 3. Good health, Utilization, Cross-Sectional Studies, Social Class, Joint replacement registry, Orthopedic surgery, Physical therapy, Female, Hip Prosthesis, lcsh:RC925-935, business, Delivery of Health Care, Research Article, Demography
Abstract

Background The utilization of total hip replacement (THR) surgery is rapidly increasing, however few data examine whether these procedures are associated with socioeconomic status (SES) within Australia. This study examined primary THR across SES for both genders for the Barwon Statistical Division (BSD) of Victoria, Australia. Methods Using the Australian Orthopaedic Association National Joint Replacement Registry data for 2006–7, primary THR with a diagnosis of osteoarthritis (OA) among residents of the BSD was ascertained. The Index of Relative Socioeconomic Disadvantage was used to measure SES; determined by matching residential addresses with Australian Bureau of Statistics census data. The data were categorised into quintiles; quintile 1 indicating the most disadvantaged. Age- and sex-specific rates of primary THR per 1,000 person years were reported for 10-year age bands using the total population at risk. Results Females accounted for 46.9% of the 642 primary THR performed during 2006–7. THR utilization per 1,000 person years was 1.9 for males and 1.5 for females. The highest utilization of primary THR was observed in those aged 70–79 years (males 6.1, and females 5.4 per 1,000 person years). Overall, the U-shaped pattern of THR across SES gave the appearance of bimodality for both males and females, whereby rates were greater for both the most disadvantaged and least disadvantaged groups. Conclusions Further work on a larger scale is required to determine whether relationships between SES and THR utilization for the diagnosis of OA is attributable to lifestyle factors related to SES, or alternatively reflects geographic and health system biases. Identifying contributing factors associated with SES may enhance resource planning and enable more effective and focussed preventive strategies for hip OA.

Full Text
View/download PDF

3. Opioid use after total hip arthroplasty surgery is associated with revision surgery

Author

Maria C.S. Inacio, Elizabeth W. Paxton, Elizabeth E. Roughead, Stephen E. Graves, Nicole L. Pratt, Inacio, Maria CS, Pratt, Nicole L, Roughead, Elizabeth E, Paxton, Elizabeth W, and Graves, Stephen E

Subjects
Male, revision, total hip arthroplasty, Time Factors, Sports medicine, Arthroplasty, Replacement, Hip, medicine.medical_treatment, Administration, Oral, Comorbidity, 0302 clinical medicine, Risk Factors, Epidemiology, Odds Ratio, Orthopedics and Sports Medicine, 030212 general & internal medicine, Pain Measurement, Aged, 80 and over, Pain, Postoperative, 030222 orthopedics, Rehabilitation, Hazard ratio, Age Factors, Arthralgia, 3. Good health, Analgesics, Opioid, Treatment Outcome, Quartile, Cohort, Female, Hip Joint, Analgesic drugs, Research Article, Reoperation, medicine.medical_specialty, Revision, analgesic drugs, Administration, Cutaneous, Risk Assessment, 03 medical and health sciences, Rheumatology, Internal medicine, medicine, Humans, Aged, Retrospective Studies, Chi-Square Distribution, business.industry, opioids, Surgery, Opioids, Multivariate Analysis, Orthopedic surgery, Total hip arthroplasty, business
Abstract

Background: Pain is an indication for total hip arthroplasty (THA) and it should be resolved post-surgery. Because patients' pain is typically treated pharmacologically we tested whether opioid use can be used as a surrogate for patient-reported pain and as an indicator for early surgical failure. Specifically, we evaluated whether the amount of opioids taken within the year after THA was associated with one and five years risk of revision surgery. Methods: A cohort of 9943 THAs (01/2001-12/2012) was evaluated. Post-operative opioid use was the exposure of interest and cumulative daily oral morphine equivalent (OME) amounts were calculated. Total OMEs/90-day periods were categorised into quartiles. Revisions within one and five years were the outcomes of interest. Results: Of the THAs, 2.0 % (N = 200) were revised within one year and 4.2 % (N = 413) within five years. After adjustments for gender, age, surgical indication, co-morbidities, and other analgesics, revision was associated with amount of OMEs in the second quarter after THA (days 91-180 after discharge). Patients on medium-high amounts of OME (400-1119 mg) had higher risk of one (hazard ratio (HR) = 2.22, 95 % CI 1.08-4.56) and five year (HR = 1.66, 95 % CI 1.08-2.56) revision than a patient not taking opioids. During the same period, patients taking the highest amounts of OMEs (≥1120 mg) had a 2.64 (95 % CI 1.03-6.74) times higher risk of one year and a 2.11 (95 % CI 1.13-3.96) times higher risk of five year revision. Conclusions: Opioid use 91-180 days post-surgery is associated with higher risk of revision surgery and therefore is an early and useful indicator for surgical failure. Refereed/Peer-reviewed

Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results