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KCE Reports 113 Volume Outcome 191
Table 7.25: Total knee arthroplasty: In-hospital outcome (during index stay)
Number
total
number
outcome
%
outcome
Death 11017 17 0.15
Deep venous thrombosis 11017 45 0.41
Pulmonary embolism 11017 51 0.46
Deep wound infection 11017 7 0.06
7.2.5.2 Complications within 90 days
Among the 11 017 patients who underwent a total knee replacement in 2004, 6 633
patients (60.7%) were hospitalized at least once again in 2004 or 2005. For 1 875
patients (17%), the second admission took place within 90 days following the index
admission.
The 90 days interval starts with the total knee replacement index admission. This period
of time was chosen previously by Katz. et al. 325 The outcome measures are very similar
to those for THR.
Information on the 90-day complication rate is retrieved from two sources:
1. the index admission: on the basis of the secondary diagnosis;
2. consecutive readmissions that occurred within 90 days from index admission:
on the basis of the principal diagnosis or procedure.
The following ICD-9-CM diagnosis (as primary or secondary diagnosis) or procedure
codes are used:
• Pulmonary embolism: 415.1 “Pulmonary embolism and infarction as
principal diagnosis”
• Deep venous thrombosis (DVT): 451.1x “Phlebitis and thrombophlebitis
of deep vessels of lower extremities”
• Deep wound infection: 996.66 “Infection and inflammatory reaction due
to internal joint prosthesis”
• Mechanical complication: 996.4 “Mechanical complication of internal
orthopaedic device, implant, & graft”
• Other complications: at least one ICD-9-CM diagnosis code indicating
“Other complications of internal prosthetic device, implant, & graft”:
o 996.77 “Due to internal joint prosthesis”
o or 996.78 “Due to other internal orthopaedic device, implant, &
graft”
o or 996.79 “Due to other internal prosthetic device, implant, &
graft”
• Dislocation of knee within 90 days from initial admission: at least one of
the following codes:
o diagnosis 836.x “Dislocation of knee”
o or procedure 79.76 “Closed reduction of dislocation of knee”
o or procedure 79.86 “Open reduction of dislocation of knee”
• Acute myocardial infarction: 410 “Acute myocardial infarction”
• Pneumonia: at least one of the following ICD-9-CM diagnosis codes:
o 480.x “Viral pneumonia”
o 481.x “Pneumococcal pneumonia”
o 482.x “Other bacterial pneumonia”
o 483.x “Pneumonia due to other specified organism”
o 485.x “Bronchopneumonia, organism unspecified”
o 486.x “Pneumonia, organism unspecified”