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. 2012 Nov;30(11):1811-21.
doi: 10.1002/jor.22139. Epub 2012 Apr 19.

Epidemiology and risk factors for perioperative mortality after total hip and knee arthroplasty

Stavros G Memtsoudis  1 , Matthias Pumberger, Yan Ma, Ya-Lin Chiu, Gerhard Fritsch, Peter Gerner, Lazaros Poultsides, Alejandro Gonzalez Della Valle
Affiliations

Epidemiology and risk factors for perioperative mortality after total hip and knee arthroplasty

Stavros G Memtsoudis et al. J Orthop Res. 2012 Nov.

Abstract

The perioperative mortality of total knee and hip arthroplasties (TKA, THA) remains a major concern among health care providers and their patients. The increase in utilization of TKA and THA makes it imperative to be aware of factors that are associated with this unfortunate event. Therefore we analyzed the Nationwide Inpatient Sample data from 1998 to 2008 and compared admissions with perioperative mortality to those that survived their hospitalization. An estimated total of 4,438,213 TKA and 2,182,121 THA procedures were performed in the United States between 1998 and 2008. The average mortality rate for TKA was 0.13% and 0.18% for THA, or 0.34 and 0.44 events per 1,000 inpatient days, respectively. Independent risk factors for in-hospital mortality were advanced age, male gender, ethnic minority background, emergency admission as well as a number of comorbidities and complications. Furthermore, we demonstrated that the timing of death occurred earlier after TKA when compared to THA, with 50% of fatalities occurring by day 4 versus day 6 of the hospitalization, respectively. This study provides nationally representative information on risk factors for and timing of perioperative mortality after TKA and THA. Our data can be used to assess the risk for perioperative mortality and to develop targeted intervention to decrease such risk.

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Figures

Figure 1
Figure 1
This figure shows the number of discharges and mortalities after total knee athroplasty (TKA) by hospitalization day.
Figure 2
Figure 2
This figure shows the number of discharges and mortalities after total hip athroplasty (THA) by hospitalization day.
See this image and copyright information in PMC

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