Early death following primary total hip arthroplasty
Mark D Jones1, Michael C Parry1, Michael R Whitehouse1
1Musculoskeletal Research Unit, University of Bristol, Avon Orthopaedic Centre, Southmead Hospital, Bristol, UK.
The Journal of Arthroplasty
|March 22, 2014
Summary
Primary total hip arthroplasty shows a small excess surgical mortality at 30 days, mainly from myocardial infarction and pneumonia. This risk diminishes by 90 days post-operation.
Area of Science:
- Orthopedic Surgery
- Public Health
- Epidemiology
Background:
- Total hip arthroplasty (THA) is a common procedure for hip osteoarthritis.
- Assessing perioperative mortality is crucial for patient safety and healthcare policy.
- Previous studies may have used inadequate control groups for mortality comparisons.
Purpose of the Study:
- To determine the excess surgical mortality associated with primary total hip arthroplasty.
- To analyze the timing and causes of death following THA.
- To compare mortality rates against a matched waiting list population.
Main Methods:
- Retrospective cohort study comparing THA patients with a matched waiting list control group.
- Mortality rates calculated at 30 and 90 days post-procedure or waitlist addition.
- Causes of death ascertained from death certificates.
Main Results:
- An excess surgical mortality of 0.256% was observed at 30 days post-THA (P = 0.002).
- This excess mortality was not statistically significant at 90 days (0.025%, P = 0.892).
- Myocardial infarction and pneumonia were the most frequent causes of death; age and gender did not significantly impact mortality.
Conclusions:
- Primary THA is associated with a statistically significant, albeit small, excess surgical mortality at 30 days.
- The use of an appropriate control population highlights short-term risks.
- The observed excess mortality risk diminishes substantially by 90 days post-surgery.
