Patient-reported complications after elective joint replacement surgery Are they correct?

University College Hospital, 235 Euston Road, London NW1 2BU, UK.
The Bone & Joint Journal (Impact Factor: 3.31). 08/2012; 94(8):1120-5. DOI: 10.1302/0301-620X.94B8.29040
Source: PubMed

ABSTRACT Using general practitioner records and hospital notes and through direct telephone conversation with patients, we investigated the accuracy of nine patient-reported complications gathered from a self-completed questionnaire after elective joint replacement surgery of the hip and knee. A total of 402 post-discharge complications were reported after 8546 elective operations that were undertaken within a three-year period. These were reported by 136 men and 240 women with a mean age of 71.8 years (34 to 93). A total of 319 reported complications (79.4%; 95% confidence interval 75.4 to 83.3) were confirmed to be correct. High rates of correct reporting were demonstrated for infection (94.5%) and the need for further surgery (100%), whereas the rates of reporting deep-vein thrombosis (DVT), pulmonary embolism, myocardial infarction and stroke were lower (75% to 84.2%). Dislocation, peri-prosthetic fractures and nerve palsy had modest rates of correct reporting (36% to 57.1%). More patients who had knee surgery delivered incorrect reports of dislocation (p = 0.001) and DVT (p = 0.013). Despite these variations, it appears that post-operative complications may form part of a larger patient-reported outcome programme after elective joint replacement surgery.

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    • "Currently, there is limited literature on the additional value of patient-reported complications following surgery. We are only aware of three studies (Dushey et al, 2011; Alazzawi et al, 2012; Greenbaum et al, 2012) examining concordance of clinical and patient-reported complications, in elective hip and knee replacement surgery. These suggest variable rates of correct reporting for different complications with good concordance for clearly defined complications such as deep vein thrombosis (DVT) and pulmonary embolism (PE) and poor concordance for those less clearly defined such as 'major bleeding'. "
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