Hospitalizations for total hip arthroplasty after renal transplantation in the United States

被引:33
作者
Bucci, JR
Oglesby, RJ
Agodoa, LY
Abbott, KC [1 ]
机构
[1] Walter Reed Army Med Ctr, Serv Nephrol, Washington, DC 20307 USA
[2] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA
[3] Walter Reed Army Med Ctr, Rheumatol Serv, Washington, DC 20307 USA
[4] NIDDK, NIH, Bethesda, MD USA
关键词
African American; age; avascular necrosis of the hip; body mass index; Caucasian; complications; diabetes; female; gender; mortality; rejection; renal transplant; repeat; revision; risk; total hip arthroplasty; USRDS;
D O I
10.1034/j.1600-6143.2002.21020.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
The national incidence of and factors associated with total hip arthroplasty in renal transplant recipients has not been reported. We conducted an historical cohort study of 42096 renal transplant recipients in the United States between 1 July 1994 and 30 June 1998. Primary outcomes were associations with hospitalizations for a primary discharge code of total hip arthroplasty (ICD9 procedure code 81.51x) within 3 years after renal transplant using Cox regression. Renal transplant recipients had a cumulative incidence of total hip arthroplasty of 5.1 episodes/1000 person-years, which is 5-8 times higher than reported in the general population. Avascular necrosis of the hip was the most frequent primary diagnosis associated with total hip arthroplasty in this population (72% of cases). Repeat surgeries were performed in 27% of patients with avascular necrosis, vs. 15% with other diagnoses. Total hip arthroplasty was more frequent in transplant recipients who were older, African American, or who experienced allograft rejection. Mortality after total hip arthroplasty was 0.21% at 30 days and 15% at 3 years, similar to the mortality of all transplant recipients. The most common indication for total hip arthroplasty after renal transplant is avascular necrosis of the hip, in contrast to the general population. Although repeat surgeries are common, total hip arthroplasty is well tolerated and is not associated with increased mortality in this population.
引用
收藏
页码:999 / 1004
页数:6
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