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Increased risk of peripheral arterial disease after hip replacement: an 11-year retrospective population-based cohort
Tzu-Yi Chou1, Ta-Wei Su, Herng-Jeng Jou
1From the Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung (T-YC, P-YY); Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan (T-WS); Department of Orthopedic Surgery, Kuang Tien General Hospital, Taichung (H-JJ); Department of Nursing, Hungkuang University, Taichung (H-JJ); School of Medicine, China Medical University, Taichung (P-YY, H-JC, C-HM); Management Office for Health Data, China Medical University Hospital, Taichung (H-JC, C-HM); Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung (C-HK); and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK).
Abstract:
The correlation between hip replacement (Hip-Rep) and peripheral arterial disease (PAD) remains uncertain. Thus, we investigated the relationship between Hip-Rep and risk of developing PAD in a nationwide retrospective cohort study.National Health Insurance data were used to assemble a cohort of patients who were diagnosed from 2000 to 2011. Patients with a history of PAD were excluded. A total of 5284 patients who received a Hip-Rep and 21,124 matched controls were enrolled. We used Cox proportional hazards regression model to analyze the adjusted risk of developing PAD.The risk of developing PAD in the Hip-Rep group was 1.24-fold higher (95% CI = 1.05-1.48) than that in the control group. The adjusted risk of developing PAD increased with patient age; compared with patients aged 50 years or younger, the risk among those ages at least 80 years was 4.87-fold higher. Patients with diabetes exhibited the highest risk of developing PAD (HR = 1.58, 95% CI = 1.34-1.86). Compared with patients who had not received a Hip-Rep or reported any comorbidity, patients who received a Hip-Rep were 2.45-fold more likely to develop PAD (95% CI = 1.54-3.89); the risk increased with the number of comorbidities.Hip-Reps might be independently linked with an increased risk of developing PAD. The impact of Hip-Reps on this risk was greater in women and patients ages 65 years and younger and within the first year of follow-up.
