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Published on: September 7, 2022

Chronic Corticosteroid Use Is Associated with Higher Perioperative Morbidity After Elective Primary Total Hip

Assil Mahamid1,2, Hamza Murad1,2, Miri Elgabsi3

  • 1Department of Orthopedics, Hasharon Hospital, Rabin Medical Center, Tel Aviv University, Tel Aviv 6997801, Israel.

Journal of Clinical Medicine
|July 15, 2026
PubMed

Insights

Chronic corticosteroid use increases risks for patients undergoing elective total hip arthroplasty (THA). Steroid users face higher rates of complications, major bleeding, and in-hospital mortality, highlighting a need for increased clinical recognition of this perioperative risk.

Area of Science:

  • Orthopedic Surgery
  • Pharmacology
  • Health Services Research

Background:

  • Chronic corticosteroid use is prevalent for autoimmune and inflammatory conditions.
  • The perioperative risks associated with chronic steroid use in elective total hip arthroplasty (THA) are not fully understood.

Purpose of the Study:

  • To evaluate the association between chronic corticosteroid use and postoperative complications and hospital outcomes after elective primary THA.

Main Methods:

  • Retrospective cohort study using the National Inpatient Sample (2016-2021).
  • Identified adult patients undergoing elective primary THA.
  • Defined chronic corticosteroid use by ICD-10-CM code Z79.52.
  • Utilized multivariable logistic regression and propensity score matching (PSM).

Main Results:

  • Chronic corticosteroid use (0.91% of cohort) was linked to higher comorbidity burden.
  • Associated with increased odds of any postoperative complication (OR 1.32), major bleeding (OR 1.46), prolonged hospitalization (OR 1.26), and in-hospital mortality (OR 2.53).
  • Matched cohort analysis confirmed significant association with overall complications (OR 1.84) and acute kidney injury (OR 2.10).

Conclusions:

  • Chronic corticosteroid use is an independent predictor of increased perioperative morbidity after elective THA.
  • Highlights chronic steroid use as a marker for increased perioperative risk.
  • Suggests the need for greater clinical recognition and informs future perioperative management strategies.

Keywords:
bleedingcorticosteroidspostoperative complicationstotal hip arthroplastyvenous thromboembolism

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