Patients older than 90 years have increased risk for major complications after THA
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Key takeaways:
- Patients aged 90 years and older are at increased risk for major complications after THA.
- These patients have lower mortality rates than those in the corresponding age group within the general population.
According to published results, patients aged 90 years and older, often referred to as nonagenarians, are at an increased risk for major complications after total hip arthroplasty.
Researchers used the German Arthroplasty Registry to perform an observational cohort study of 263,967 THA procedures from November 2012 to December 2021 with a mean follow up of 1,070 days. Patients were grouped into four cohorts based on age: 60 to 69 years (n = 91,363), 70 to 79 years (n = 117,324), 80 to 89 years (n = 53,421) and 90 years and older (n = 1,859). Outcomes included major and minor complications, defined by the Elixhauser Comorbidity Index (ECI), as well as mortality.
Overall, ECI was highest in nonagenarians (4.76) compared with patients 60 to 69 years of age (–2.07), patients 70 to 79 years of age (–0.64) and patients 80 to 89 years of age (1.48). Nonagenarians also had the highest incidences of congestive heart failure, pulmonary circulation disorders, insulin-dependent diabetes, renal failure, coagulopathy, and fluid and electrolyte disorders, according to the study.
Among nonagenarians, researchers noted an association between increased mortality and major complications as patients without a major complication had a 1-year survival rate of 94.4%, while patients with a major complication had a 1-year survival rate of 79.8%.
Researchers also found nonagenarians within the study group had lower mortality rates than those in the corresponding age group within the general population. Among nonagenarians, 1-year mortality was 10.5% in men and 6.4% in women within the study group, while 1-year mortality was 18.5% in men and 14.7% in women within the general population.
“The fact that mortality was still lower than in the general population shows that this aspect can be controlled by careful patient selection and adequate preparation,” the researchers wrote in the study. “Therefore, elective THA can be appropriately considered by surgeons and patients when symptoms of hip osteoarthritis are present in nonagenarians,” they concluded.
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