Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Jan 26;55(4):823-838.
doi: 10.1007/s43465-021-00357-x. eCollection 2021 Aug.

The Update on Instruments Used for Evaluation of Comorbidities in Total Hip Arthroplasty

Łukasz Pulik  1 , Michał Podgajny  2 , Wiktor Kaczyński  2 , Sylwia Sarzyńska  1 , Paweł Łęgosz  1
Affiliations
Review

The Update on Instruments Used for Evaluation of Comorbidities in Total Hip Arthroplasty

Łukasz Pulik et al. Indian J Orthop. .

Abstract

Introduction: It is a well-established fact that concomitant diseases can affect the outcome of total hip arthroplasty (THA). Therefore, careful preoperative assessment of a patient's comorbidity burden is a necessity, and it should be a part of routine screening as THA is associated with a significant number of complications. To measure the multimorbidity, dedicated clinical tools are used.

Methods: The article is a systematic review of instruments used to evaluate comorbidities in THA studies. To create a list of available instruments for assessing patient's comorbidities, the search of medical databases (PubMed, Web of Science, Embase) for indices with proven impact on revision risk, adverse events, mortality, or patient's physical functioning was performed by two independent researchers.

Results: The initial search led to identifying 564 articles from which 26 were included in this review. The measurement tools used were: The Charlson Comorbidity Index (18/26), Society of Anesthesiology classification (10/26), Elixhauser Comorbidity Method (6/26), and modified Frailty Index (5/26). The following outcomes were measured: quality of life and physical function (8/26), complications (10/26), mortality (8/26), length of stay (6/26), readmission (5/26), reoperation (2/26), satisfaction (2/26), blood transfusion (2/26), surgery delay or cancelation (1/26), cost of care (1/26), risk of falls (1/26), and use of painkillers (1/26). Further research resulted in a comprehensive list of eleven indices suitable for use in THA outcomes studies.

Conclusion: The comorbidity assessment tools used in THA studies present a high heterogeneity level, and there is no particular system that has been uniformly adopted. This review can serve as a help and an essential guide for researchers in the field.

Keywords: Arthroplasty; Chronic diseases; Comorbidity; Hip; Multimorbidity; Orthopedics; Osteoarthritis; Replacement.

PubMed Disclaimer

Conflict of interest statement

Conflict of interestOn behalf of all authors, the corresponding author ŁP states that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Summary of search and review process
See this image and copyright information in PMC

References

    1. Pabinger C, Geissler A. Utilization rates of hip arthroplasty in OECD countries. Osteoarthritis Cartilage. 2014;22(6):734–741. - PubMed
    1. Barros AAG, et al. Efficacy evaluation of a protocol for safe hip surgery (total hip arthroplasty) Revista Brasileira de Ortopedia. 2017;52(Suppl 1):29–33. - PMC - PubMed
    1. Hustedt JW, et al. Calculating the cost and risk of comorbidities in total joint arthroplasty in the United States. Journal of Arthroplasty. 2017;32(2):355–361.e1. - PubMed
    1. Pulik Ł, et al. An update on joint-specific outcome measures in total hip replacement. Reumatologia. 2020;58(2):107–115. - PMC - PubMed
    1. Jain NB, et al. Comorbidities increase complication rates in patients having arthroplasty. Clinical Orthopaedics and Related Research. 2005;435:232–238. - PubMed

LinkOut - more resources