Postdischarge pneumonia after hip arthroplasty: a population‑based study of 55 842 patients in Poland

Alloplasty is one of the most frequently performed procedures, as it hugely improves the quality of life.

The purpose of this study was to determine the incidence, risk factors, and clinical implications of postdischarge pneumonia after hip endoprosthesis in Polish adults.

This retrospective study was conducted using the database of the National Health Fund (Narodowy Fundusz Zdrowia) containing data from 55 842 hip arthroplasties performed in 2017.

Postdischarge pneumonia was identified in 371 patients and accounted for 26.6% of all postdischarge infections, with incidence rate of 0.7%. Multivariable analysis showed a significantly higher risk of pneumonia in patients aged 65 and older (odds ratio [OR], 3.5; 95% CI, 2.40-5.03), urgently admitted (OR, 4.0; 95% CI, 3.16-4.98), operated in winter (OR, 1.7; 95% CI, 1.37-2.11), and hospitalized in the intensive care unit (OR, 5.9; 95% CI, 3.65-9.46). Preventative factors were pre‑surgery treatment for diseases of the musculoskeletal system (OR, 0.7; 95% CI, 0.59-0.91) and postoperative rehabilitation (both outpatient and inpatient; OR, 0.3; 95% CI, 0.10-0.99 and OR, 0.7; 95% CI, 0.42-0.99, respectively). Seventy patients (18.9% of pneumonia cases) required inpatient pneumonia treatment. The in‑hospital case fatality rate observed in postdischarge pneumonia was 21.4%.

Pneumonia is one of the most common postoperative infections after hip endoprosthesis, especially in winter, requiring rehospitalization. Efforts should be made to prepare patients in the perioperative period.