Factors associated with injection utilization in knee OA patients

Hi, my name is Bradley Powers, and I'm a 4th year medical student at LSU School of Medicine in New Orleans, Louisiana.

And this is factors associated with Injection utilization in Knee Osteoarthritis patients.

Before we go ahead, I just want to thank the rest of my teammates that are listed below for help with this project.

So here's the overview of the presentation. We'll start with the project description, including the project objective. We'll then move into the methodology, the key findings and results, and finish with the discussion.

So the project description, our objective for this project was to identify factors associated with Knee Injection utilization.

The main results we found from this project were that women received an initial Injection more often than men.

And women also received an additional Injection more often than men.

Otherwise, race, insurance, and age at diagnosis did not affect utilization of steroid injections.

For our methods, this project was a Retrospective chart review, including 761 patients with newly diagnosed symptomatic Knee Osteoarthritis.

From the years 2015 to 2017.

They had a mean follow-up of 3.8 years, and within that followup they did not have a Total knee arthroplasty.

The average age of diagnosis for our patients was 60 years old, and 66.8% of them had severe Knee Osteoarthritis indicated by our KL score equal to 4. KL score is a scoring system for radiographs using different features on the X-ray to signify very.

severity of Osteoarthritis.

Within our project group, we had 70% female patients and 30% male.

All insurances were included, but Medicaid was 39%, Private 32%, and the rest were Medicare Advantage and Medicare.

And for race, we had, we had 50% black or African American patients, 35% white, and 15% Other.

So on the first results slide, we have our utilization of Knee injections.

By sex, and so on the left-hand side, we see that females received.

The initial Injection more often than males did.

And that's significant with our P value of 0.016. On the right-hand side, we only take the patients with a KL score of 4, signifying our most severe patients.

And females still receive the initial Injection more often than males.

However, our P value is 0.07, but so it's not significant, but it still shows that females have more than males.

On this slide, this shows our additional steroid injections by sex, so on the left-hand side.

We see that females receive the additional steroid Injection more often than males with a P value of 0.014, a significant difference. On the right-hand side, we select our most severe patients and we still see a significant difference between females and males for the additional steroid Injection.

Lastly, we look at our utilization between Other factors on the left-hand side for initial Injection versus no Injection at all. We see that the insurance status, race, and age at diagnosis.

Did not play a significant role in receiving an Injection.

The last piece there, our CUS Pain score, that's a Pain, that's a patient reported Pain score.

And it signifies with our significant P value that the initial Injection provided a significant amount of Pain relief to our patients that received a steroid Injection.

On the righthand side for additional injections, we see that insurance status, race, and age of diagnosis again did not play a significant role.

However, the Ku's Pain score was not significantly different.

Signifying that additional injections may or may not have provided Pain relief with our patients.

So to wrap up our results with our discussion, first, we see that over 770% of our patients received a steroid Injection.

Next we see that women received.

more initial injections and reces more per year and more additional injections.

Although the difference between females and males decreases as we only include the more severe patients, females still receive more injections per year. This could be attributed to the difference in disease onset, disease progression, or differences in Pain reception of Osteoarthritis between females and males, but that would require further investigation.

Next we see that patients with severe Knee Osteoarthritis initially chose to receive steroid injections and experienced Pain relief with the initial Injection. However, with additional injections, they did not necessarily receive Pain relief, suggesting that steroid injections may lose their effectiveness over time, but again, that would require further investigation.

And lastly, we saw that race, insurance status, and age at diagnosis of Osteoarthritis did not play a role in Injection utilization.

Thank you for listening to my presentation, and I will, will take questions below in the comment section.

Thanks.