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Mortality following revision joint arthroplasty: is age a factor?
Thomas K Fehring1, Susan M Odum, Keith Fehring
1OrthoCarolina Hip and Knee Center, Charlotte, North Carolina 28207, USA. thomas.fehring@ orthocarolina.com
Orthopedics
|October 20, 2010
Summary
Revision joint surgery has very low perioperative mortality across all age groups. Age should not be the sole factor in determining patient survival after revision total hip or knee surgery.
Area of Science:
- Orthopedic Surgery
- Geriatric Medicine
- Public Health
Background:
- Increasing life expectancy and demand for joint replacements necessitate more revision surgeries.
- Revision joint surgeries are complex, with longer operative times and higher blood loss.
- A common perception is that older patients face higher mortality rates after revision arthroplasty.
Purpose of the Study:
- To evaluate perioperative mortality rates after revision total hip and knee arthroplasty.
- To analyze mortality rates stratified by age groups (under 70, 70-79, and over 80).
- To determine if age alone should dictate survival expectations and resource allocation for revision surgery.
Main Methods:
- Retrospective analysis of 1737 patients undergoing revision total joint surgery.
- Inclusion criteria: patients at least 2 years postoperative.
- Calculation and stratification of perioperative mortality (0-3 months post-op) by surgery type and age.
Main Results:
- Overall perioperative mortality rate was 0.7%.
- Mortality rates by age: 0.2% (under 70), 0.8% (70-79), and 2.63% (over 80).
- 541 patients died more than 1 year post-surgery, averaging 6.9 years to death.
Conclusions:
- Perioperative mortality rates for revision total joint surgery are low across all age groups.
- Age should not be the sole criterion for assessing perioperative survival after revision surgery.
- Observed survival rates support resource allocation for revision procedures irrespective of patient age.
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