Duration of the Increase in Early Postoperative Mortality After Elective Hip and Knee Replacement

Lie, Stein Atle; Pratt, Nicole; Ryan, Philip; Engesæter, Lars B.; Havelin, Leif I.; Furnes, Ove; Graves, Stephen
January 2010
Journal of Bone & Joint Surgery, American Volume;Jan2010, Vol. 92-A Issue 1, p58
Academic Journal
Background: There is increased early postoperative mortality after elective joint replacement surgery. However, the magnitude and duration of the increased mortality are uncertain. Methods: Data on total knee and total hip replacement from the comprehensive national registries in Australia and Norway were assessed. Only patients between fifty and eighty years of age with osteoarthritis were included. Overall, the study included 81,856 patients with a total knee replacement and 106,254 patients with a total hip replacement. Smoothed intensity curves were calculated to show the change in mortality for the early postoperative period, whereas the effects of risk factors were studied with use of the nonparametric additive Aalen model. Results: We found that early postoperative mortality was increased for the first twenty-six postoperative days (95% confidence interval, twenty-two to forty-one days). The excess mortality, compared with a baseline mortality (calculated as the average mortality from Day 100 to Day 200), for these twenty-six days was estimated to be 0.12% (95% confidence interval, 0.11% to 0.14%). The most important risk factors for excessive early postoperative mortality were male sex and high age (more than seventy years of age). Conclusions: There is an increased, but low, early postoperative mortality following lower extremity joint replacement surgery. The excess mortality persists, but steadily decreases, for approximately the first twenty-six postoperative days. Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.


Related Articles

  • Comparing patient outcomes after THA and TKA: is there a difference?  // Advances in Orthopaedics;Sep2010, Vol. 2 Issue 3, p116 

    The findings of this study suggest that patients undergoing primary total hip arthroplasty have better clinical outcomes than patients undergoing primary total knee arthroplasty at 1-year follow-up.

  • Patient-Related Risk Factors for Periprosthetic Joint Infection and Postoperative Mortality Following Total Hip Arthroplasty in Medicare Patients. Bozic, Kevin J.; Lau, Edmund; Kurtz, Steven; Ong, Kevin; Rubash, Harry; Vail, Thomas P.; Berry, Daniel J. // Journal of Bone & Joint Surgery, American Volume;5/2/2012, Vol. 94-A Issue 9, p794 

    Background: The patient-related risk factors for periprosthetic joint infection and postoperative mortality in elderly patients undergoing total hip arthroplasty are poorly understood. The purpose of this study was to identify the specific patient comorbidities that are associated with an...

  • Evaluating quality of life outcomes following joint replacement: psychometric evaluation of a short form of the WHOQOL-Bref. Snell, Deborah; Siegert, Richard; Surgenor, Lois; Dunn, Jennifer; Hooper, Gary; Snell, Deborah L; Siegert, Richard J; Surgenor, Lois J; Dunn, Jennifer A; Hooper, Gary J // Quality of Life Research;Jan2016, Vol. 25 Issue 1, p51 

    Purpose: Reducing participant burden is important in health research and clinical assessment. We examined the psychometric properties of the EUROHIS-QOL 8-item index, a short version of the 26-item World Health Organisation Quality of Life questionnaire (WHOQOL-Bref), in a sample of...

  • Patient characteristics affecting the prognosis of total hip and knee joint arthroplasty: a systematic review. Santaguida, Pasqualina L.; Hawker, Gillian A.; Hudak, Pamela L.; Glazier, Richard; Mahomed, Nizar N.; Kreder, Hans J.; Coyte, Peter C.; Wright, James G. // Canadian Journal of Surgery;Dec2008, Vol. 51 Issue 6, p428 

    The article reports on the results of research which was conducted in an effort to address how patient characteristics influence the outcomes of total hip and knee arthroplasty in patients with osteoarthritis. researchers found that while younger age and male sex increased the risk of revision...

  • Relationship between self-reported and performance-based tests in a hip and knee joint replacement population. Gandhi, Rajiv; Tsvetkov, Dmitry; Davey, J. Roderick; Syed, Khalid A.; Mahomed, Nizar N. // Clinical Rheumatology;Mar2009, Vol. 28 Issue 3, p253 

    Our objectives were: (1) to assess the relationship between self-reported measures (Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and Medical Outcomes Study Short Form-36 (SF-36)) and a performance-based timed-up-and-go (TUG) test in a hip and knee joint replacement...

  • Total Joint Arthroplasty: Is Perfection Attainable? GONZALEZ, MARK H.; MIHALKO, WILLIAM M. // AAOS Now;Mar2014, Vol. 8 Issue 3, p42 

    The article offers information on the achievement of the desired total joint arthroplasty (TJA) outcome. Topics discussed include the obstacles to the perfection of the process, challenges to TJA implants, and factors to the success and failure of total knee arthroplasty (TKA) and total hip...

  • Athletic activity post-lower limb arthroplasty - What are the determining factors? Douglas, S.; Jassim, S. S.; Haddad, F. S. // Muscles, Ligaments & Tendons Journal (MLTJ);2012 Supplement, p56 

    Introduction: Joint Arthroplasty (JA) is a successful surgical procedure for end stage joint disease. The number of younger patients with high functional demands having this surgery is increasing and it is known that athletes are susceptible to joint disease and many will wish to continue...

  • Predicting the need for high-dependency care in patients undergoing hip and knee revision surgery. Rashid, Mohammed; Stafford, Giles; Chirodian, Nish // European Journal of Orthopaedic Surgery & Traumatology;Jan2012, Vol. 22 Issue 1, p47 

    Introduction: Revision hip and knee arthroplasty surgery may cause great physiological stress to what is commonly an aged, infirm patient population. In some orthopaedic units, it is routine practice to book high-dependency unit (HDU) beds for postoperative revision arthroplasty surgery...

  • Too few joint patients get clot busting drugs after discharge. Spurgeon, David // BMJ: British Medical Journal (International Edition);6/14/2008, Vol. 336 Issue 7657, p1330 

    The article reports on research which was published in the "Canadian Medical Association Journal". The research found that less than one in five elderly patients in Canada received anticoagulants after discharge from hospitals following hip or knee replacement surgery, and that such patients are...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics