Comparison of perioperative complications in patients with and without rheumatoid arthritis who receive total elbow replacement
ABSTRACT Total elbow replacement is a well-recognized surgical treatment for patients with advanced rheumatoid arthritis (RA) of the elbow. At present, there is minimal literature outlining the perioperative complications associated with total elbow replacement. We endeavored to identify complication rates and hospital disposition differences between patients with and without RA who received a total elbow replacement. Data from the Nationwide Inpatient Sample was used to capture 3,617 patients who received a total elbow arthroplasty between 1988-2005. Of these, 888 had a primary diagnosis of RA and were compared against patients without RA. Analyses addressed perioperative complications and hospital disposition factors, such as charges and length of stay. Overall complication rates were very low with only 2 variables, respiratory complications (P = .01) and renal failure (P = .04) demonstrating significantly worse outcomes in patients without RA (P = .01). Patients without RA had also had longer lengths of stay (P < 0.01). There were 9 reported perioperative deaths. The findings suggest that the perioperative complications of a total elbow replacement for all patients studied are few and that outcomes in patients with RA are nearly equivalent to those in patients without RA.
Conference Paper: The Impact of Technological Advances on Programmable Controllers[Show abstract] [Hide abstract]
ABSTRACT: An input/output system of intelligent, programmable, solid-state power I/O modules inherently distributed to the point of control through integrated serial communications has been developed to provide a stand-alone, user-configurable I/O module. Design of this special I/O product was driven by the demand for greater diagnostics capability and lower installed costs required by programmable controller users. The product development, involving a new 5,500 gate equivalent VLSI chip and a smart power switch, required a high degree of computer simulation to reduce development cycles and provide a design optimizing reliability without adding unnecessary cost. This paper will outline the product and its advances in the programmable control market followed by a discussion of how computer simulation was used in the design.Design Automation, 1985. 22nd Conference on; 07/1985
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ABSTRACT: This is an overview of the current literature on malunion after midshaft clavicle fracture. Anatomy, trauma mechanism, classification, incidence, symptoms, prevention, and treatment options are all discussed. The conclusion is that clavicle malunion is a distinct clinical entity that can be treated successfully.Acta Orthopaedica 04/2010; 81(3):273-9. DOI:10.3109/17453674.2010.480939 · 2.45 Impact Factor
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ABSTRACT: The long-term survival rate of total shoulder arthroplasty (TSA) is comparable to hip and knee arthroplasty. Although TSA is considered a safe and effective procedure with low complications in patients with osteoarthritis and rheumatoid arthritis (RA), data are lacking on perioperative complications. Complication rates and hospital disposition differences between patients with and without RA who underwent TSA were investigated. We hypothesized that RA patients would have poorer perioperative outcomes after TSA. Data from the Nationwide Inpatient Sample was used to capture 25,398 patients between 1988 and 2005 who underwent TSA. Of these, 1,186 patients had a primary diagnosis of RA and were compared with 24,212 patients without RA. Analyses addressed perioperative complications and hospital disposition factors using bivariate and logistic regression models. Overall complication rates were exceptionally low in both groups. Hospital disposition factors were significantly different between the 2 groups. The RA cohort had shorter average lengths of stay, higher likelihood of routine discharge, and lower inflation-adjusted cost before and after adjustment for covariates. The occurrence of complications in the perioperative setting was less than 1% for both study groups in most variables investigated, and there were only minimal differences in perioperative complications between the groups. The significant differences in hospital disposition factors suggest that patients with RA may have less complex hospital stays and may be more comfortable being discharged under their own care. Recent studies describing the overall improvement in the management of patients with RA may also help explain these findings. The findings suggest that the perioperative complications of a total shoulder replacement for patients with and without RA are similar. Contrary to our expectations, TSA patients with RA had shorter and less costly hospital stays and were more likely to have routine discharge. Complications are likely more long-term in nature than detected in this study and require longer follow-up beyond perioperative periods for fruition.Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.] 01/2011; 20(1):77-85. DOI:10.1016/j.jse.2010.03.005 · 2.37 Impact Factor