Patient–surgeon sex discordance impacts adverse events but does not affect patient-reported satisfaction after primary total hip arthroplasty: a regional register-based cohort study

Authors

  • Per Jolbäck Department of Orthopaedics, Institute of Clinical Science, The Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Orthopaedics, Skaraborg Hospital, Skövde https://orcid.org/0000-0001-9402-9506
  • Sebastian Mukka Department of Surgical and Perioperative Sciences (Orthopedics), Umeå University, Umeå https://orcid.org/0000-0002-5469-2730
  • Kristin Wetterling Department of Orthopaedics, Institute of Clinical Science, The Sahlgrenska Academy, University of Gothenburg, Gothenburg
  • Maizar Mohaddes Department of Orthopaedics, Institute of Clinical Science, The Sahlgrenska Academy, University of Gothenburg, Gothenburg; Swedish Arthroplasty Register, Gothenburg; Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
  • Anne Garland Department of Surgical Sciences/Orthopaedics, Institute of Surgical Sciences, Uppsala University Hospital, Uppsala; Department of Orthopaedics, Visby Hospital, Visby https://orcid.org/0000-0002-9659-1516

DOI:

https://doi.org/10.2340/17453674.2022.6228

Keywords:

Arthroplasty, Hip, Surgeon sex

Abstract

Background and purpose: The sex of the surgeon has been proposed to be associated with a disparity in clinical outcomes after different surgical procedures. We investigated the association between surgeon–patient sex discordance and adverse events (AEs) and surgical AEs (SAEs) within 90 days after primary total hip arthroplasty (THA). We also investigated patient-reported satisfaction with surgical outcomes 1 year after the surgery.
Patients and methods: We conducted a register-based cohort study including primary THAs performed due to osteoarthritis between 2008 and 2016 at 10 publicly managed hospitals in western Sweden. Hospital data was linked to the Swedish Arthroplasty Register and a regional patient register. Logistic regression models investigated discordant sex of patients and surgeons on AEs/SAEs and patient-reported satisfaction with the surgical outcome.
Results: 11,993 primary THAs were included in the study. The proportion of AEs for the concordant group was 7.3% and for the discordant group 6.1%. For SAEs, the proportion was 5.0% for the concordant group and 4.3% for the discordant group. After adjustment the discordant group still had a lower likelihood of an AE or SAE than the concordant group: adjusted odds ratio (aOR) for AE (0.82, 95%CI 0.71–0.95) and for SAE (0.86, CI 0.72–0.99). No association was detected between patient-reported satisfaction and sex discordance.
Conclusion: Sex discordance between surgeons and patients is linked to a decreased risk of an AE but not a lower level of patient-reported satisfaction with the surgical outcome.

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Published

2022-12-27

How to Cite

Jolbäck, P., Mukka, S., Wetterling, K., Mohaddes, M., & Garland, A. (2022). Patient–surgeon sex discordance impacts adverse events but does not affect patient-reported satisfaction after primary total hip arthroplasty: a regional register-based cohort study. Acta Orthopaedica, 93, 922–929. https://doi.org/10.2340/17453674.2022.6228

Issue

Section

Non-randomized clinical study

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