Declining early mortality after hip and knee arthroplasty.
Ian A Harris1,2,3, Alesha Hatton1, Richard de Steiger1,4
1Australian Orthopaedic Association National Joint Replacement Registry, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
ANZ Journal of Surgery
|November 20, 2019
Summary
Thirty-day mortality after total hip arthroplasty (THA) and total knee arthroplasty (TKA) significantly decreased between 2003 and 2017. This trend suggests improvements in surgical and post-operative patient care over time.
Area of Science:
- Orthopaedic Surgery
- Public Health
- Epidemiology
Background:
- Assessing temporal trends in mortality following major joint replacement is crucial for evaluating surgical safety.
- The Australian Orthopaedic Association National Joint Replacement Registry provides a robust dataset for such analyses.
Purpose of the Study:
- To quantify the period effect on 30-day mortality after total hip arthroplasty (THA) and total knee arthroplasty (TKA).
- To analyze changes in mortality rates over time using national registry data.
Main Methods:
- An observational study utilizing Australian national registry data (2003-2017).
- Inclusion criteria: primary elective conventional THA and TKA for osteoarthritis.
- Mortality data linked with the National Death Index and Australian Bureau of Statistics.
Main Results:
- Unadjusted 30-day mortality for THA decreased from 0.23% (2003) to 0.06% (2017).
- Unadjusted 30-day mortality for TKA decreased from 0.17% (2003) to 0.08% (2017).
- Incident rate ratios for mortality, adjusted for age and gender, showed a significant decreasing trend over the study period for both procedures.
Conclusions:
- A significant decline in 30-day mortality was observed for both THA and TKA from 2003 to 2017.
- Improvements in intra-operative and post-operative patient management are likely contributors to this observed mortality reduction.
