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Published on: September 7, 2022
Postoperative Complications and Associated Risk Factors Following Total Hip Arthroplasty in Elderly Patients: A
Menghang Wu1, Gang Xie1, Mingqing Peng2
1Department of Anesthesiology, China National Pharmaceutical Group Chongqing Southwest Aluminum Hospital, Chongqing, 401326 China.
Background:
As the global population ages, total hip arthroplasty (THA) is increasingly performed in elderly patients who are vulnerable to perioperative complications. However, data on the short-term burden and predictors of such complications in real-world cohorts remain limited.
Methods:
We retrospectively analyzed patients aged ≥ 70 years who underwent elective primary THA between January 2021 and December 2024. Postoperative complications within 90 days were identified and categorized. Propensity score matching (PSM, 1:1) was applied based on age, sex, and BMI, and univariate logistic regression was used to assess perioperative risk factors.
Results:
Among 310 patients (mean age 77.1 ± 3.4 years; 68.7% female), 106 (34.2%) experienced at least one postoperative complication within 90 days. The most common events were pulmonary infection (7.1%), urinary tract infection (4.2%), surgical site infection (3.2%), delirium (2.9%), and deep vein thrombosis (2.9%). After PSM, 196 patients were included (98 with and 98 without complications). Logistic regression identified delayed ambulation (OR 3.13, 95% CI 1.59-6.15), preoperative hypoalbuminemia (OR 2.72), blood loss ≥ 500 mL (OR 2.34), intraoperative transfusion (OR 2.25), preoperative anemia (OR 2.15), and Charlson comorbidity index ≥ 3 (OR 1.88) as significant predictors (all P < 0.05).
Conclusion:
Postoperative complications were common in elderly THA patients, primarily infectious or functional. Clinical frailty and perioperative factors including nutritional deficits, blood loss, and delayed mobilization significantly increased risk. Early identification and optimization of these factors may help reduce postoperative morbidity in older surgical candidates.
Supplementary Information:
The online version contains supplementary material available at 10.1007/s43465-026-01703-7.
