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Impact of valvular heart disease on hip replacement: a retrospective nationwide inpatient sample database study

Qiang Lian1, Jian Wang1, Yun Lian2

  • 1Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue, Guangzhou, 510515, Guangdong, China.

BMC Musculoskeletal Disorders
|October 10, 2021
PubMed

Insights

Valvular heart disease (VHD) and aortic stenosis (AS) increase mortality and complications following hip replacement surgery. These conditions are linked to higher costs and adverse outcomes, necessitating careful patient evaluation.

Area of Science:

  • Cardiovascular Surgery
  • Orthopedic Surgery
  • Public Health

Background:

  • Valvular heart disease (VHD) impacts hip replacement outcomes.
  • Aortic stenosis (AS) is a specific VHD with clinical implications before hip arthroplasty.

Purpose of the Study:

  • To investigate the influence of VHD on hip replacement.
  • To analyze the clinical effects of AS preceding total/partial hip arthroplasty.

Main Methods:

  • Retrospective cohort study using NIS database (2005-2014).
  • Independent t-tests and chi-square tests for patient characteristics.
  • Multivariate regression for correlations in demographics, comorbidities, complications, costs, and time.

Main Results:

  • VHD present in 5.56% and AS in 0.03% of hip replacement patients.
  • VHD associated with female patients, elective admission, higher comorbidity index, large/teaching hospitals, and urban locations.
  • VHD is a risk factor for mortality, acute cardiac events, pulmonary edema, cerebrovascular events, and renal failure.
  • AS patients are older, more likely female, and have elective admissions.
  • AS linked to perioperative complications like cardiac events and hepatic failure.
  • Both VHD and AS correlate with increased mortality and hospitalization costs.

Conclusions:

  • VHD independently predicts higher mortality rates after hip arthroplasty.
  • VHD is associated with increased surgical and medical complications post-hip replacement.
  • VHD and AS necessitate careful perioperative management in hip replacement patients.
Abstract

Keywords:
Aortic stenosisHip replacementValvular heart disease

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