Age as an Independent Risk Factor for Postoperative Morbidity and Mortality After Total Joint Arthroplasty in Patients 90 Years of Age or Older

被引:66
作者
D'Apuzzo, Michele R. [1 ]
Pao, Andrew W. [1 ]
Novicoff, Wendy M. [1 ]
Browne, James A. [1 ]
机构
[1] Univ Virginia, Dept Orthopaed Surg, Charlottesville, VA 22908 USA
关键词
hip arthroplasty; knee arthroplasty; postoperative complications; mortality; TOTAL KNEE ARTHROPLASTY; TOTAL HIP-ARTHROPLASTY; UNITED-STATES; NONAGENARIANS;
D O I
10.1016/j.arth.2013.07.045
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
The population of patients over 90 years of age has experienced the fastest growth in recent years. The number of primary total joint arthroplasties (TJA) has also been increasing. Our objectives were to examine in-hospital morbidity, mortality and resource consumption following primary TJA in patients older than 89 years at the national level. Nationwide Inpatient Sample was used to identify 8,340,167 patients who underwent TJA between 1993 and 2008, 58,355 (0.7%) were 90 years of age or older. Older patients were at higher risk of developing cardiac (OR 2.5; 95% CI 2.4-2.6), neurological (OR 2.1; 95% CI 1.8-2.4), respiratory complications and higher risk of mortality (OR 11.5; 95% CI 10.93-12.1) after controlling for baseline comorbidities. Age is an independent risk factor for postoperative complications and mortality. Our data can be used to educate patients on the risks before undergoing primary TJA and aid physicians in assessing and adjusting perioperative risk. (C) 2014 Elsevier Inc. All rights reserved.
引用
收藏
页码:477 / 480
页数:4
相关论文
共 17 条
[1]
Total hip and knee arthroplasty in nonagenarians [J].
Alfonso, Daniel T. ;
Howell, Damani ;
Strauss, Eric J. ;
Di Cesare, Paul E. .
JOURNAL OF ARTHROPLASTY, 2007, 22 (06) :807-811
[2]
[Anonymous], 2010, OLD POP 2010
[3]
[Anonymous], 1996, COMP AN HCUP NHD S13, V13
[4]
Total knee arthroplasty in patients 90 years of age and older [J].
Belmar, CJ ;
Barth, P ;
Lonner, JH ;
Lotke, PA .
JOURNAL OF ARTHROPLASTY, 1999, 14 (08) :911-914
[5]
Total joint arthroplasty in the extremely elderly - Hip and knee arthroplasty after entering the 89th year of life [J].
Berend, ME ;
Thong, AE ;
Faris, GW ;
Newbern, G ;
Pierson, JL ;
Ritter, MA .
JOURNAL OF ARTHROPLASTY, 2003, 18 (07) :817-821
[6]
The Epidemiology of Revision Total Knee Arthroplasty in the United States [J].
Bozic, Kevin J. ;
Kurtz, Steven M. ;
Lau, Edmund ;
Ong, Kevin ;
Chiu, Vanessa ;
Vail, Thomas P. ;
Rubash, Harry E. ;
Berry, Daniel J. .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2010, 468 (01) :45-51
[7]
The Epidemiology of Revision Total Hip Arthroplasty in the United States [J].
Bozic, Kevin J. ;
Kurtz, Steven M. ;
Lau, Edmund ;
Ong, Kevin ;
Vail, Thomas P. ;
Berry, Daniel J. .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2009, 91A (01) :128-133
[8]
MORBIDITY AND MORTALITY IN ASSOCIATION WITH OPERATIONS ON THE LUMBAR SPINE - THE INFLUENCE OF AGE, DIAGNOSIS, AND PROCEDURE [J].
DEYO, RA ;
CHERKIN, DC ;
LOESER, JD ;
BIGOS, SJ ;
CIOL, MA .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1992, 74A (04) :536-543
[9]
ADAPTING A CLINICAL COMORBIDITY INDEX FOR USE WITH ICD-9-CM ADMINISTRATIVE DATABASES [J].
DEYO, RA ;
CHERKIN, DC ;
CIOL, MA .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 1992, 45 (06) :613-619
[10]
HCUP Quality Control Procedures, HCUP QUAL CONTR PROC