In-hospital deaths following elective total joint arthroplasty

Elective hip or knee arthroplasty is considered a relatively safe orthopedic procedure. However, given the number of procedures performed, catastrophic complications, such as death, occur. Between January 1995 and March 2001, 3438 patients underwent elective hip or knee arthroplasty at our institution. Patients with diagnoses of fracture or malignancy were excluded. Extensive chart reviews were performed on 9 postoperative deaths. The American Society of Anesthesiologists (ASA) score was significantly related to the incidence of postoperative death. Specifically, ASA class III patients were more likely to encounter postoperative death. Additionally, a higher rate of postoperative complications occurred in the deceased group.