The Journal of Arthroplasty
Volume 25, Issue 1 , Pages 19-26, January 2010

Risk Factors for Perioperative Mortality After Lower Extremity Arthroplasty: A Population-Based Study of 6,901,324 Patient Discharges☆

  • Stavros G. Memtsoudis, MD, PhD

      Affiliations

    • Department of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York
    • Corresponding Author InformationReprint requests: Stavros G. Memtsoudis, MD, PhD, Department of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York, NY 10021.
    • ,
  • Alejandro González Della Valle, MD

      Affiliations

    • Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York
    • ,
  • Melanie C. Besculides, DrPH, MPH

      Affiliations

    • Mathematica Policy Research, Inc., P.O. Box 2393, Princeton, New Jersey
    • ,
  • Matthew Esposito

      Affiliations

    • Department of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York
    • ,
  • Panagiotis Koulouvaris, MD, PhD

      Affiliations

    • Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York
    • ,
  • Eduardo A. Salvati, MD

      Affiliations

    • Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York

Received 28 April 2008; accepted 15 November 2008. published online 24 December 2008.

Abstract 

The goal of this study was to provide nationally representative data on characteristics of patients who died after hip and knee arthroplasty and to determine risk factors for such outcome. Using national in-patient data collected between 1990 and 2004, we identified a cumulative in-hospital mortality rate of 0.35% among an estimated 6 901 324 procedures. The strongest independent risk factors for in-hospital mortality were pulmonary embolism and cerebrovascular complications, which increased the odds for a fatal outcome by approximately 40-fold. Preoperative risk factors for in-hospital mortality were revision total hip arthroplasty, advanced age, and the presence of a number of comorbid diseases, predominantly dementia, renal, and cerebrovascular disease. Our results can be used to identify patients at risk for fatal outcome and implement interventions to reduce such risk.

Keywords: mortality, risk factors, total hip arthroplasty, total knee arthroplasty, complications

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

☆ This study was funded by the Hospital for Special Surgery Anesthesiology Young Investigator Award provided by the Department of Anesthesiology and the Hospital for Special Surgery.

PII: S0883-5403(08)00855-3

doi:10.1016/j.arth.2008.11.010

The Journal of Arthroplasty
Volume 25, Issue 1 , Pages 19-26, January 2010

Article Tools

* Image Usage & Resolution