Characterizing Comorbidities in Total Joint Arthroplasty in a Safety-Net Hospital Using Age-Adjusted…

Cohort studyJournal of the American Academy of Orthopaedic Surgeons. Global research & reviews· Aug 2026

Characterizing Comorbidities in Total Joint Arthroplasty in a Safety-Net Hospital Using Age-Adjusted Charlson Comorbidity Index.

Matthew Chan, Lily Khabie, Noshin Nuzhat … Ira Kirschenbaum

GeriatricsCohort studyClinical practiceQ2IF 1.7

Nearly all safety-net hospital joint arthroplasty patients had at least one comorbidity

Characterizing Comorbidities in Total Joint Arthroplasty in a Safety-Net Hospital Using Age-Adjusted Charlson Comorbidity Index.

Matthew Chan … Ira Kirschenbaum

Journal of the American Academy of Orthopaedic Surgeons · Aug 2026 · Q2 in General Medicine

Background

The joint arthroplasty population has a high number of comorbidities at the time of surgery, which increases the cost of care per episode.

Purpose

The goal of this study was to analyze the distribution of comorbid diseases in patients who have undergone total joint arthroplasty at our institution, which serves the poorest congressional district in the United States.

Methods

A retrospective analysis was conducted by reviewing consecutive patients who underwent total joint arthroplasty between 2008 and 2023 (N = 3011).

n = 3011

Results

nearly every patient had at least one other health condition going in

Hypertension

69.01%

Obesity

45.37%

Diabetes

30.09%

Anemia

23.05%

More results

Within the patient population concerning CCI scores, 10.93% of the patient population scored 0, 22.42% scored 1, 27.33% scored 2, 20.86% scored 3, 10.73% scored 4, and 7.74% scored 5 and above.

The mean CCI score was 2.25 ± 1.50.

More results

The most frequently occurring comorbid conditions according to hospital criteria in this population were hypertension (N = 2078, 69.01%), obesity (N = 1366, 45.37%), diabetes (N = 906, 30.09%), and anemia (N = 694, 23.05%).

A total of 19.10% of patients were current smokers.

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Conclusion · 1 of 3

The major finding from this retrospective analysis revealed the presence of a high incidence of comorbidities in the our health system's total joint arthroplasty population.

Conclusion · 2 of 3

We confirmed that this closed urban population is a unique subset of at-risk individuals who are undergoing TJA, which may increase their complication rates.

Conclusion · 3 of 3

Consideration for proper risk stratification in communities like this need to be considered.

Characterizing Comorbidities in Total Joint Arthroplasty in a Safety-Net Hospital Using Age-Adjusted Charlson Comorbidity Index.

Characterizing Comorbidities in Total Joint Arthroplasty in a Safety-Net Hospital Using Age-Adjusted Charlson Comorbidity Index.

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