Department of Orthopedics, University of Calgary, Calgary, AB, Canada.
University of Texas Southwestern, Dallas, TX, USA.
Arch Orthop Trauma Surg. 2023 Oct;143(10):6423-6430. doi: 10.1007/s00402-023-04850-w. Epub 2023 Mar 28.
With prolonged life expectancy and advancements in prosthetic designs, the proportion of patients belonging to diverse age groups undergoing total hip arthroplasty (THA) has progressively increased. In this context, the details regarding risk factors associated with mortality after THA, and its prevalence need to be clearly understood. This study sought to identify the possible co-morbidities associated with post-THA mortality.
Based on Nationwide Inpatient Sample (NIS) database, patients undergoing THA from 2016 to 2019 (using ICD-10CMP) were identified. The included cohort was stratified into two groups: "early mortality" and "no mortality" groups. The data regarding patients' demographics, co-morbidities, and associated complications were compared between the groups.
Overall, 337,249 patients underwent THA, among whom, 332 (0.1%) died during their hospital admission ("early mortality" group). The remaining patients were included under "no mortality" group (336,917 patients). There was significantly higher mortality in the patients, who underwent emergent THA (as compared with elective THA: odd's ratio 0.075; p < 0.001). Based on multivariate analysis, presence of liver cirrhosis, chronic kidney disease (CKD) and previous history of organ transplant increased the odds of mortality {odds ratio [Exp (B)]} after THA by 4.66- (p < 0.001), 2.37-fold (p < 0.001) and 1.91-fold (p = 0.04), respectively. Among post-THA complications, acute renal failure (ARF), pulmonary embolism (PE), pneumonia, myocardial infarction (MI), and prosthetic dislocation increased the odds of post-THA mortality by 20.64-fold (p < 0.001), 19.35-fold (p < 0.001), 8.21-fold (p < 0.001), 2.71-fold (p = 0.05) and 2.54-fold (p < 0.001), respectively.
THA is a safe surgery with low mortality rate during early post-operative period. Cirrhosis, CKD, and previous history of organ transplant were the most common co-morbidities associated with post-THA mortality. Among post-operative complications, ARF, PE, pneumonia, MI, and prosthetic dislocation substantially enhanced the odds of post-THA mortality.
随着预期寿命的延长和假肢设计的进步，接受全髋关节置换术 (THA) 的患者群体中属于不同年龄组的比例逐渐增加。在这种情况下，需要清楚地了解与 THA 后死亡率相关的风险因素及其流行程度。本研究旨在确定与 THA 后死亡率相关的可能合并症。
基于全国住院患者样本 (NIS) 数据库，确定了 2016 年至 2019 年期间接受 THA 的患者（使用 ICD-10CMP）。将纳入的队列分为两组：“早期死亡率”组和“无死亡率”组。比较两组患者的人口统计学、合并症和相关并发症数据。
总体而言，有 337249 名患者接受了 THA，其中 332 名（0.1%）在住院期间死亡（“早期死亡率”组）。其余患者被归入“无死亡率”组（336917 名患者）。急诊 THA 患者的死亡率明显更高（与择期 THA 相比：优势比 0.075；p<0.001）。基于多变量分析，肝硬化、慢性肾脏病 (CKD) 和既往器官移植史使 THA 后死亡的几率增加了 4.66 倍（p<0.001）、2.37 倍（p<0.001）和 1.91 倍（p=0.04）。THA 后并发症中，急性肾衰竭 (ARF)、肺栓塞 (PE)、肺炎、心肌梗死 (MI) 和假体脱位使 THA 后死亡率增加了 20.64 倍（p<0.001）、19.35 倍（p<0.001）、8.21 倍（p<0.001）、2.71 倍（p=0.05）和 2.54 倍（p<0.001）。
THA 是一种安全的手术，术后早期死亡率低。肝硬化、CKD 和既往器官移植史是与 THA 后死亡率相关的最常见合并症。在术后并发症中，ARF、PE、肺炎、MI 和假体脱位显著增加了 THA 后死亡率的几率。
