Format

Send to

Choose Destination
Perm J. 2017;21:16-171. doi: 10.7812/TPP/16-171.

Mortality After Total Knee and Total Hip Arthroplasty in a Large Integrated Health Care System.

Author information

1
Epidemiologist in the Surgical Outcomes and Analysis Department at Kaiser Permanente in San Diego, CA. maria.cs.inacio@kp.org.
2
Orthopedic Surgeon at the Sacramento Medical Center in CA. mark.t.dillon@kp.org.
3
Orthopedic Surgeon at the Sunset Medical Center in Los Angeles, CA. alex.x.miric@kp.org.
4
Orthopedic Surgeon at the Harbor City Medical Center in CA. ronald.a.navarro@kp.org.
5
Director of the Surgical Outcomes and Analysis Department at Kaiser Permanente in San Diego, CA. liz.w.paxton@kp.org.

Abstract

CONTEXT:

The number of excess deaths associated with elective total joint arthroplasty in the US is not well understood.

OBJECTIVE:

To evaluate one-year postoperative mortality among patients with elective primary and revision arthroplasty procedures of the hip and knee.

DESIGN:

A retrospective analysis was conducted of hip and knee arthroplasties performed in 2010. Procedure type, procedure volume, patient age and sex, and mortality were obtained from an institutional total joint replacement registry. An integrated health care system population was the sampling frame for the study subjects and was the reference group for the study.

MAIN OUTCOME MEASURES:

Standardized 1-year mortality ratios (SMRs) and 95% confidence intervals (CIs) were calculated.

RESULTS:

A total of 10,163 primary total knee arthroplasties (TKAs), 4963 primary total hip arthroplasties (THAs), 606 revision TKAs, and 496 revision THAs were evaluated. Patients undergoing primary THA (SMR = 0.6, 95% CI = 0.4-0.7) and TKA (SMR = 0.4, 95% CI = 0.3-0.5) had lower odds of mortality than expected. Patients with revision TKA had higher-than-expected mortality odds (SMR = 1.8, 95% CI = 1.1-2.5), whereas patients with revision THA (SMR = 0.9, 95% CI = 0.4-1.5) did not have higher-than-expected odds of mortality.

CONCLUSION:

Understanding excess mortality after joint surgery allows clinicians to evaluate current practices and to determine whether certain groups are at higher-than-expected mortality risk after surgery.

PMID:
28746022
PMCID:
PMC5528856
DOI:
10.7812/TPP/16-171
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for PubMed Central
Loading ...
Support Center