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Age and cardiac disease were strongest predictors of complications after THA
Patient age of 80 years and older or 70 to 79 years and renal insufficiency best predicted mortality among patients who underwent primary total hip arthroplasty, whereas the strongest predictors of any postoperative complications included age 80 years or older and cardiac disease, according to study results.
Researchers searched the National Surgical Quality Improvement Program and identified 17,640 patients who underwent primary unilateral total hip arthroplasty (THA) from 2006 to 2011. The researchers gathered demographic variables and previous or current medical comorbidities and documented surgical data, such as mode of anesthesia and total operative time, as well as presence and type of postoperative complications, mortality and duration of hospital stay.
Study results showed a 0.35% 30-day mortality rate. The researchers recorded 1,074 complications in 867 patients, with 261 patients experiencing 317 major systemic complications and 424 patients experiencing 443 minor systemic complications.
The more common major systemic complications included cardiovascular and septic in source, whereas the most common systemic complications included urinary tract infection and deep venous thrombosis.
The researchers also found 143 major local complications, including deep wound infection, perioperative fracture needing surgical treatment and peripheral nerve injury, and 169 minor local complications, such as superficial wound infection and wound dehiscence.
According to study results, 2.35% of patients either died or experienced a major complication in the first 30 days following primary THA.
Important predictors of developing any postoperative complication or major systemic complication included age 80 years and older, cardiac disease, operative time of more than 141 minutes, American Society of Anesthesiologists classification of 3 or greater, chronic obstructive pulmonary disease and diabetes.
The researchers found the most powerful predictors for developing a major local complication were body mass index (BMI) of 40 or greater and operative time of more than 141 minutes, whereas BMI of 40 or greater, chronic obstructive pulmonary disease, operative time of more than 141 minutes and diabetes were the most important factors associated with minor local complications.
Disclosure: See the study for a full list of all authors’ relevant financial disclosures.