Venishetty Nikit, Jose Jonathan, Purudappa Prabhudev Prasad A, Mounasamy Varatharaj, Sambandam Senthil
Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, 79905, USA.
Carroll Senior High School, Dallas, TX, 76092, USA.
Arthroplasty. 2024 Jun 7;6(1):36. doi: 10.1186/s42836-024-00247-1.
Hip hemiarthroplasty (HHA) is one of the most common types of orthopedic surgery. With the prevalence and utilization of the surgery increasing year after year, this procedure is found to be associated with severe postoperative complications and eventually mortality. Thus, it is crucial to understand the factors that increase the risk of mortality following HHA.
Using the Nationwide Inpatient Sample (NIS) database, patients undergoing HHA from 2016 to 2019 were identified. This sample was stratified into a mortality group and a control group. The data regarding patients' demographics, co-morbidities, and associated complications were compared between the groups.
Of the 84,067 patients who underwent the HHA procedures, 1,327 (1.6%) patients died. Additionally, the mortality group had a higher percentage of patients who were non-electively admitted (P < 0.001) and diabetic patients with complications (P < 0.001), but lower incidences of tobacco-related disorders (P < 0.001). Significant differences were also seen in age (P < 0.001), length of stay (P < 0.001), and total charges (P < 0.001) between the two groups. Preoperatively, those aged > 70 years (OR: 2.11, 95% CI [1.74, 2.56], P < 0.001) had diabetes without complications (OR: 0.32, 95% CI [0.23, 0.44], P < 0.001), tobacco-related disorders (OR: 0.24, 95% CI [0.17, 0.34], P < 0.001) and increased rates of mortality after HHA. Postoperatively, conditions, such as pulmonary embolisms (OR: 6.62, 95% CI [5.07, 8.65], P < 0.001), acute renal failure (OR: 4.58 95% CI [4.09, 5.13], P < 0.001), pneumonia (95% CI [2.72, 3.83], P < 0.001), and myocardial infarctions (OR: 2.65, 95% CI [1.80, 3.92], P < 0.001) increased likelihood of death after undergoing HHA. Patients who were electively admitted (OR: 0.46 95% CI [0.35, 0.61], P < 0.001) had preoperative obesity (OR: 0.67, 95% CI [0.44, 0.84], P = 0.002), and a periprosthetic dislocation (OR: 0.51, 95% CI [0.31, 0.83], P = 0.007) and were found to have a decreased risk of mortality following THA.
Analysis of pre- and postoperative complications relating to HHA revealed that several comorbidities and postoperative complications increased the odds of mortality. Old age, pulmonary embolisms, acute renal failure, pneumonia, and myocardial infraction enhanced the odds of post-HHA mortality.
髋关节半关节成形术（HHA）是最常见的骨科手术类型之一。随着该手术的患病率和使用率逐年上升，人们发现该手术与严重的术后并发症以及最终的死亡率相关。因此，了解增加HHA术后死亡风险的因素至关重要。
使用全国住院患者样本（NIS）数据库，确定2016年至2019年接受HHA的患者。该样本被分为死亡组和对照组。比较两组患者的人口统计学、合并症和相关并发症数据。
在接受HHA手术的84,067例患者中，1,327例（1.6%）死亡。此外，死亡组中非择期入院患者（P < 0.001）和有并发症的糖尿病患者（P < 0.001）的比例较高，但烟草相关疾病的发生率较低（P < 0.001）。两组在年龄（P < 0.001）、住院时间（P < 0.001）和总费用（P < 0.001）方面也存在显著差异。术前，年龄>70岁（OR：2.11，95%CI[1.74, 2.56]，P < 0.001）、无并发症的糖尿病（OR：0.32，95%CI[0.23, 0.44]，P < 0.001）、烟草相关疾病（OR：0.24，95%CI[0.17, 0.34]，P < 0.001）以及HHA术后死亡率增加。术后，肺栓塞（OR：6.62，95%CI[5.07, 8.65]，P < 0.001）、急性肾衰竭（OR：4.58，95%CI[4.09, 5.13]，P < 0.001）、肺炎（95%CI[2.72, 3.83]，P < 0.001）和心肌梗死（OR：2.65，95%CI[1.80, 3.92]，P < 0.001）等情况增加了HHA术后死亡的可能性。择期入院患者（OR：0.46，95%CI[0.35, 0.61]，P < 0.001）、术前肥胖（OR：0.67，95%CI[0.44, 0.84]，P = 0.002）以及假体周围脱位（OR：0.51，95%CI[0.31, 0.83]，P = 0.007）的患者在THA术后死亡风险降低。
对与HHA相关的术前和术后并发症的分析表明，几种合并症和术后并发症增加了死亡几率。老年、肺栓塞、急性肾衰竭、肺炎和心肌梗死增加了HHA术后死亡的几率。
