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

Abstract

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

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

Patients and methods: 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.

Results: 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%.

Conclusions: 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.