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Total Hip Arthroplasty in 6690 Patients with Inflammatory Arthritis: Effect of Medical Comorbidities and Age on Early Mortality
Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, Sect Orthoped & Sports Med, SE-17176 Stockholm, Sweden.; Sahlgrens Univ Hosp, Inst Clin Sci, Dept Orthoped, Gothenburg, Sweden.
Sahlgrens Univ Hosp, Inst Clin Sci, Dept Orthoped, Gothenburg, Sweden.
Sahlgrens Univ Hosp, Inst Clin Sci, Dept Orthoped, Gothenburg, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
2016 (English)In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 43, no 7, 1320-1327 p.Article in journal (Refereed) Published
Abstract [en]

Objective. We analyzed early mortality after total hip arthroplasty ( THA) in patients with inflammatory arthritis ( IA), adjusting for medical comorbidities and socioeconomic background.

Methods. Data on 6690 patients with IA who underwent THA during 1992-2012 were extracted from the Swedish Hip Arthroplasty Register. Data on comorbidity, measured using the Charlson Comorbidity Index ( CCI), and socioeconomic data were gathered from the Swedish National Inpatient Register and Statistics Sweden. The CCI was divided into low ( 0), moderate ( 1-2), and high (> 2). Cox proportional hazards models were fitted to calculate adjusted HR of early mortality, with 95% CI.

Results. Twenty-five patients ( 0.4%) died within 0-90 days, giving a 90-day unadjusted survival rate of 99.6% ( CI 99.5-99.8). Comorbidity was associated with an increased risk of death within 90 days postoperatively [ high vs low CCI: adjusted HR 9.0 ( CI 1.6-49.9)]. There was a trend toward lower risk of death during the period 1999-2005, although patients operated on during this period had more comorbidities than those operated on from 1992 to 1998. A large proportion of patients was re-admitted to hospital within 90 days after the index procedure ( 30.2%), but rarely for cardiovascular reasons.

Conclusion. Medical comorbidity and an age above 75 years are associated with a substantial increase in the risk of early death after THA in patients with IA. Awareness of potential risk factors may alert clinicians and thus improve perioperative care.

Place, publisher, year, edition, pages
2016. Vol. 43, no 7, 1320-1327 p.
Keyword [en]
EPIDEMIOLOGY, INFLAMMATORY ARTHRITIS, ORTHOPEDIC SURGERY
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-303133DOI: 10.3899/jrheum.151287ISI: 000380882000010PubMedID: 27134261OAI: oai:DiVA.org:uu-303133DiVA: diva2:971074
Available from: 2016-09-15 Created: 2016-09-15 Last updated: 2016-09-15Bibliographically approved

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