Venishetty Nikit, Toutoungy Michel, Beale Jack, Martinez Jack, Wukich Dane K, Mounasamy Varatharaj, Huo Michael H, Sambandam Senthil
Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA.
University of Texas Southwestern, Dallas, TX, USA.
Geriatr Orthop Surg Rehabil. 2023 May 22;14:21514593231178624. doi: 10.1177/21514593231178624. eCollection 2023.
Nonagenarians are a rapidly expanding population in the United States. These patients are met with increasing rates of hip arthritis, necessitating the need for total hip arthroplasty (THA). However, there is currently limited information on hospitalization information and perioperative complications in this population. Methods: In this retrospective study, we used the Nationwide Inpatient Sample (NIS) database from 2016-2019 to analyze the incidence of perioperative complications, length of stay (LOS), and the cost of care (COC) among patients undergoing THAs who were categorized as nonagenarians, and those who were not.
The NIS database identified 309 100 patients who underwent THAs from 2016-2019. Of those, 1864 patients (.6%) were nonagenarian, while the remaining 307 236 patients were included under the non-nonagenarian category (control). The mean age in the nonagenarian group was 90 years compared to the control group which had a mean age of 65.8 years. There was an increased incidence of mortality rate (nonagenarian group .2%, control group .03%, < .001), myocardial infarction (MI) (nonagenarian group .1%, control group .02%, = .01), acute renal failure (ARF) (nonagenarian group 5.4%, control group 1.6%, < .001), blood anemia post-operatively (nonagenarian group 28.9%, control group 17.2%, < .001), and deep vein thrombosis (DVT) (nonagenarian group .48%, control group .07%, < .001) in the nonagenarian group. The COC for the nonagenarian group was higher than that in the control group ( < .001). The mean LOS was longer in the nonagenarian group (3.1 days) in comparison to the control group (1.96 days) ( < .001).
Nonagenarians had significantly higher rates of both orthopedics and medical complications than the younger patients undergoing THAs. In addition, the nonagenarian group incurred higher COC. This information is useful for the providers to make informed decisions regarding patient care and resource utilization for nonagenarian patients undergoing THAs.
在美国，九旬老人这一群体正在迅速扩大。这些患者患髋关节炎的几率不断增加，因此需要进行全髋关节置换术（THA）。然而，目前关于该人群住院信息和围手术期并发症的资料有限。方法：在这项回顾性研究中，我们使用了2016 - 2019年的全国住院患者样本（NIS）数据库，分析被归类为九旬老人和非九旬老人的全髋关节置换术患者的围手术期并发症发生率、住院时间（LOS）和护理费用（COC）。
NIS数据库识别出2016 - 2019年接受全髋关节置换术的309100例患者。其中，1864例患者（0.6%）为九旬老人，其余307236例患者归入非九旬老人类别（对照组）。九旬老人组的平均年龄为90岁，而对照组的平均年龄为65.8岁。九旬老人组的死亡率（九旬老人组0.2%，对照组0.03%，P < 0.001）、心肌梗死（MI）（九旬老人组0.1%，对照组0.02%，P = 0.01）、急性肾衰竭（ARF）（九旬老人组5.4%，对照组1.6%，P < 0.001）、术后贫血（九旬老人组28.9%，对照组17.2%，P < 0.001）和深静脉血栓形成（DVT）（九旬老人组0.48%，对照组0.07%，P < 0.001）的发生率均有所增加。九旬老人组的护理费用高于对照组（P < 0.001）。与对照组（1.96天）相比，九旬老人组的平均住院时间更长（3.1天）（P < 0.001）。
与接受全髋关节置换术的年轻患者相比，九旬老人的骨科和内科并发症发生率显著更高。此外，九旬老人组的护理费用更高。这些信息有助于医疗服务提供者为接受全髋关节置换术的九旬老人患者的护理和资源利用做出明智决策。
