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Updated: Jan 23, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Change in the cause of inpatient mortality after arthroplasty: a retrospective study
Yuzhi Zuo1, Jin Lin1, Jin Jin1
1Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Beijing, 100730, China.
Insights
Arthroplasty in China shows a low inpatient mortality rate of 0.3%, decreasing with increased surgery volume. Pneumonia is now the leading cause of death, highlighting the need for improved perioperative management for high-risk patients.
Area of Science:
- Orthopedic Surgery
- Public Health
Background:
- Arthroplasty is a common procedure, but inpatient mortality data in China remains unclear.
- Understanding mortality rates is crucial for optimizing perioperative care.
Purpose of the Study:
- To investigate inpatient mortality rates after arthroplasty in China.
- To identify determinants of mortality and improve perioperative management.
Main Methods:
- Retrospective study analyzing arthroplasty patients at a single center.
- Collection and analysis of clinical data from deceased patients.
- Examination of mortality incidence and causes over time.
Main Results:
- Over 4176 total knee, 2164 total hip, and 1031 femoral head replacements were performed.
- Overall inpatient mortality rate was 0.3%, with a decreasing trend in recent years.
- Pneumonia emerged as the leading cause of death, surpassing cardiovascular complications.
Conclusions:
- Arthroplasty is safe and effective in China with low inpatient mortality.
- Increased surgery volume did not raise mortality due to improved perioperative management.
- High-risk patients and non-elective procedures face higher complication rates, especially pneumonia.
Background:
Although arthroplasty has been proved to be a safe and effective procedure, data regarding inpatient mortality rates associated with arthroplasty in China is unclear. We aimed to investigate the inpatient mortality rate after arthroplasty and the determinants of mortality at our center to ensure improved perioperative management.
Methods:
This retrospective study included all patients who underwent arthroplasty at our center. Clinical data of mortality patients were collected. The incidence and the causes of inpatient mortality after arthroplasty were analyzed.
Results:
A total of 4176 total knee arthroplasties, 2164 total hip arthroplasties, and 1031 femoral head replacements were performed. A rapid growth in surgery volume was observed, and more than 50% of the surgeries were performed in the last 5 years. The overall inpatient mortality rate is 0.3%; however, the mortality rate even decreased in the last 5 years. The cause of death changed over time. Pneumonia has become the leading cause of death in the past 5 years instead of cardiovascular complications.
Conclusions:
Arthroplasty is a safe and effective procedure associated with a relatively low inpatient mortality in China. And inpatient mortality does not increase as the growing surgery volume due to improvement of perioperative management. However, patients presenting with risk factors and those undergoing non-elective procedures demonstrated a relatively high incidence of postoperative complications, particularly pneumonia.
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