Statistics for orthopedic surgery 2006-2007: data from the Japanese Diagnosis Procedure Combination database

Abstract

Background: The epidemiology of orthopedic surgery cases in Japan has not been determined adequately. This study analyzed statistics in orthopedic surgery for 2006 and 2007 using the Japanese Diagnosis Procedure Combination database.

Methods: Data were collected between July 1 and December 31 in both 2006 and 2007. We selected 78 diagnostic groups of musculoskeletal diseases and trauma, and recategorized them into eight specialties: trauma, spine, knee joint, hip joint, hand, oncology, rheumatoid arthritis, others. We then focused on the following five major diseases or procedures: spinal canal stenosis, disc degeneration or herniation, hip fracture, total hip arthroplasty, and total knee arthroplasty. We extracted the following information: type of admission, use of ambulance, age, sex, preoperative co-morbidities, surgical procedures, postoperative complications such as surgical-site infection or pulmonary embolism, in-hospital mortality, length of stay, and costs.

Results: A total of 226 644 patients were included. Approximately 33% were emergency cases. More than half of the patients were >or=60 years old. The surgery rate increased with age, with 13.1% of cases in their fifties to 22% in their seventies. The highest rate of surgery of the spine (5.8%), knee joint (4.5%), or hip joint (1.8%) occurred in patients in their seventies, and the highest rate of surgery for trauma (9.1%) occurred in patients in their eighties. The overall in-hospital mortality was 0.41%. Approximately 0.63% patients had a surgical-site infection, 0.22% had pulmonary embolism, 0.54% had cardiac events, and 0.41% had respiratory disorders. Hip fracture surgeries resulted in relatively high in-hospital mortality (1.38%) and postoperative complication rate (3.6%).

Conclusions: This study presents an overview of the clinical features of orthopedic surgery in Japan, which may be of value for determining therapeutic strategies in the management of orthopedic surgery patients.