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Overlapping Orthopedic Surgery Noninferior for Patient Safety

THURSDAY, Dec. 20, 2018 -- Overlapping inpatient orthopedic surgery is noninferior to nonoverlapping surgery with respect to perioperative complications, according to a study published in the Nov. 21 issue of The Journal of Bone & Joint Surgery.

Christopher J. Dy, M.D., M.P.H., from the Washington University School of Medicine in St. Louis, and colleagues examined the safety of overlapping inpatient orthopedic surgery for all inpatient orthopedic surgical procedures performed at five academic institutions. Patients who underwent overlapping surgery, defined as two skin incisions open simultaneously for one surgeon, were compared to those who underwent nonoverlapping surgery with respect to the occurrence of a perioperative complication within 30 days of the surgical procedure.

The frequency of overlapping surgery was 40 percent among 14,135 cases. The researchers found frequencies of perioperative complications were 1 and 2 percent in the overlapping surgery and nonoverlapping surgery groups, respectively. Compared with the nonoverlapping surgery group, the overlapping surgery group was noninferior (odds ratio, 0.61); the odds of perioperative complications were reduced with overlapping surgery (odds ratio, 0.61). The overlapping surgery group had a significantly lower chance of all-cause 30-day readmission (odds ratio, 0.67) and shorter length of stay (eβ, 0.94). No difference was seen in mortality.

"It is incumbent on surgeons who perform overlapping surgery to disclose this practice to their patients and to collect patient-reported outcomes to ensure continuing patient satisfaction and to demonstrate benefit to society," the authors write.

Two authors disclosed financial ties to the medical device industry.

Abstract/Full Text

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Posted: December 2018

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