Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct;36(10):3362-3366.
doi: 10.1016/j.arth.2021.04.015. Epub 2021 Apr 21.

Competing Risk Analysis: What Does It Mean and When Do We Need It in Orthopedics Research?

Hilal Maradit Kremers  1 , Katrina L Devick  2 , Dirk R Larson  3 , David G Lewallen  4 , Daniel J Berry  4 , Cynthia S Crowson  5
Affiliations

Competing Risk Analysis: What Does It Mean and When Do We Need It in Orthopedics Research?

Hilal Maradit Kremers et al. J Arthroplasty. 2021 Oct.

Abstract

Most orthopedic studies involve survival analysis examining the time to an event of interest, such as a specific complication or revision surgery. Competing risks commonly arise in such studies when patients are at risk of more than one mutually exclusive event, such as death, or when the rate of an event depends on the rates of other competing events. In this article, we briefly describe the survival analysis censoring methodology, common fatal and nonfatal competing events, and define circumstances where standard survival analysis can fail in the setting of competing risks with real-world examples from orthopedics. Please visit the followinghttps://youtu.be/ifj_Mm3eGu8for a video that explains the highlights of the paper in practical terms.

Keywords: bias; censoring; competing risk; survival analysis; total joint arthroplasty.

PubMed Disclaimer

Figures

Figure 1:
Figure 1:. Cumulative incidence of death (Death CI) and revision probabilities using the Kaplan-Meier method (Revision KM) and the cumulative incidence function (Revision CI) in four age groups.
(published with permission from JBJS[3])
See this image and copyright information in PMC

Comment in

References

    1. Mundi S, Pindiprolu B, Simunovic N, Bhandari M. Similar mortality rates in hip fracture patients over the past 31 years. Acta Orthop 85(1): 54, 2014 - PMC - PubMed
    1. Wolkewitz M, Harbarth S, Beyersmann J. Daily chlorhexidine bathing and hospital-acquired infection. N Engl J Med 368(24): 2330, 2013 - PubMed
    1. Maradit Kremers H, Kremers WK, Sierra RJ, Lewallen DG, Berry DJ. Competing Risk of Death When Comparing Tibial Implant Types in Total Knee Arthroplasty. J Bone Joint Surg Am 98(7): 591, 2016 - PubMed
    1. Sayers A, Evans JT, Whitehouse MR, Blom AW. Are competing risks models appropriate to describe implant failure? Acta Orthop 89(3): 256, 2018 - PMC - PubMed
    1. Van Der Pas S, Nelissen R, Fiocco M. Different competing risks models for different questions may give similar results in arthroplasty registers in the presence of few events. Acta Orthop 89(2): 145, 2018 - PMC - PubMed

Publication types

LinkOut - more resources