Skip to main content
Top
Published in: European Journal of Orthopaedic Surgery & Traumatology 8/2020

01-12-2020 | Hip-TEP | Original Article

Operative time greater than 120 minutes is associated with increased pulmonary and thromboembolic complications following revision total hip arthroplasty

Authors: Alex Gu, Chapman Wei, Aaron Z. Chen, Michael-Alexander Malahias, Safa C. Fassihi, Michael P. Ast, Jiabin Liu, Michael B. Cross, Peter K. Sculco

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 8/2020

Login to get access

Abstract

Background

The aim of this study was to determine the impact of operative time on the development of early postoperative complications in patients undergoing revision total hip arthroplasty (THA).

Methods

In this retrospective cohort study, data were collected through the American College of Surgeons National Quality Improvement Program Database. All patients who underwent revision THA between 2007 and 2016 were identified and stratified into groups based on operative time|: 0–60 min, 61–120 min, 121–180 min, and > 180 min. The incidence of early postoperative adverse events with 30 days, including cardiac, pulmonary, renal, septic, thromboembolic, urinary tract, and wound complications, death, length of stay > 7 days, and unplanned return to the operating room were collected. The complications rates following revision THA were evaluated with univariate and multivariate analyses with significance set at p < 0.05.

Results

A total of 6271 revision THA patients were included for analysis. Patients who had > 120 min of operative time had a significantly increased risk of the development of pulmonary (OR: 1.339; 95% CI: 1.08–1.661; p = 0.008) and thromboembolic complications (OR: 1.34; 95% CI: 1.053–1.707; p = 0.017) and also had an extended length of stay greater than 7 days (OR: 1.413; 95% CI: 1.295–1.541; p < 0.001).

Conclusions

Increased operative time (> 120 min) during revision THA is associated with increased risk of pulmonary and thromboembolic complications, and prolonged hospitalizations (greater than seven days).
Literature
2.
go back to reference Wolford ML, Palaso K, Bercovitz A (2015) Hospitalization for total hip relacemenet among inpatients aged 45 and over: United States, 2000–2010. NCHS Data Brief 186:1–8 Wolford ML, Palaso K, Bercovitz A (2015) Hospitalization for total hip relacemenet among inpatients aged 45 and over: United States, 2000–2010. NCHS Data Brief 186:1–8
3.
go back to reference Villanueva-Martinez M, Hernandez-Barrera V, Chana-Rodriguez F, Rojo-Manaute J, Rios-Luna A, Montero JSR, Gil-de-Miguel A, Jimenez-Garcia R (2012) Trends in incidence and outcomes of revision total hip arthroplasty in Spain: a population based study. BMC Musculoskelet Disord 13:37CrossRef Villanueva-Martinez M, Hernandez-Barrera V, Chana-Rodriguez F, Rojo-Manaute J, Rios-Luna A, Montero JSR, Gil-de-Miguel A, Jimenez-Garcia R (2012) Trends in incidence and outcomes of revision total hip arthroplasty in Spain: a population based study. BMC Musculoskelet Disord 13:37CrossRef
4.
go back to reference Holt G, Hook S, Hubble M (2011) Revision total hip arthroplasty: the femoral side using cemented implants. Int Orthop 35(2):267–273CrossRef Holt G, Hook S, Hubble M (2011) Revision total hip arthroplasty: the femoral side using cemented implants. Int Orthop 35(2):267–273CrossRef
7.
go back to reference Song KH, Kim ES, Kim YK et al (2012) Differences in the risk factors for surgical site infection between total hip arthroplasty and total knee arthroplasty in the Korean Nosocomial Infections Surveillance System (KONIS). Infect Control Hosp Epidemiol 33:1086–1093CrossRef Song KH, Kim ES, Kim YK et al (2012) Differences in the risk factors for surgical site infection between total hip arthroplasty and total knee arthroplasty in the Korean Nosocomial Infections Surveillance System (KONIS). Infect Control Hosp Epidemiol 33:1086–1093CrossRef
8.
go back to reference Willis-Owen CA, Konyves A, Martin DK (2010) Factors affecting the incidence of infection in hip and knee replacement: an analysis of 5277 cases. J Bone Joint Surg Br 92:1128–1133CrossRef Willis-Owen CA, Konyves A, Martin DK (2010) Factors affecting the incidence of infection in hip and knee replacement: an analysis of 5277 cases. J Bone Joint Surg Br 92:1128–1133CrossRef
9.
go back to reference Ong KL, Kurtz SM, Lau E, Bozik KJ, Berry DJ, Parvizi J (2009) Prosthetic joint infection risk after total hip arthroplasty in the Medicare population. J Arthroplasty 24:105–109CrossRef Ong KL, Kurtz SM, Lau E, Bozik KJ, Berry DJ, Parvizi J (2009) Prosthetic joint infection risk after total hip arthroplasty in the Medicare population. J Arthroplasty 24:105–109CrossRef
10.
go back to reference Cordero-Ampuero J, de Dios M (2010) What are the risk factors for infection in hemiarthroplasties and total hip arthroplasties? Clin Orthop Relat Res 468:3268–3277CrossRef Cordero-Ampuero J, de Dios M (2010) What are the risk factors for infection in hemiarthroplasties and total hip arthroplasties? Clin Orthop Relat Res 468:3268–3277CrossRef
11.
go back to reference Ridgeway S, Wilson J, Charlet A, Katafox G, Pearson A, Coello R (2005) Infection of the surgical site after arthroplasty of the hip. J Bone Joint Surg Br 87:844–850CrossRef Ridgeway S, Wilson J, Charlet A, Katafox G, Pearson A, Coello R (2005) Infection of the surgical site after arthroplasty of the hip. J Bone Joint Surg Br 87:844–850CrossRef
12.
go back to reference Maoz G, Phillips M, Bosco J, Slover J, Stachel A, Inneh I et al (2015) The Otto Aufranc award: modifiable versus nonmodifiable risk factors for infection after arthroplasty. Clin Orthop Relat Res 473:453–459CrossRef Maoz G, Phillips M, Bosco J, Slover J, Stachel A, Inneh I et al (2015) The Otto Aufranc award: modifiable versus nonmodifiable risk factors for infection after arthroplasty. Clin Orthop Relat Res 473:453–459CrossRef
13.
go back to reference Triantafyllopoulos G, Studner O, Memtsoudis S, Poultsides LA (2015) Patient, surgery and hospital related risk factors for surgical site infections following total hip arthroplasty. Sci World J 979560:1–9CrossRef Triantafyllopoulos G, Studner O, Memtsoudis S, Poultsides LA (2015) Patient, surgery and hospital related risk factors for surgical site infections following total hip arthroplasty. Sci World J 979560:1–9CrossRef
14.
go back to reference Mraovic B, Suh D, Jacovides C, Parivizi J (2011) Perioperative hyperglycemia and postoperative infection after lower limb arthroplasty. J Diabetes Sci Technol 5:412–418CrossRef Mraovic B, Suh D, Jacovides C, Parivizi J (2011) Perioperative hyperglycemia and postoperative infection after lower limb arthroplasty. J Diabetes Sci Technol 5:412–418CrossRef
15.
go back to reference Bongartz T, Halligan CS, Osmon DR, Reinalda MS, Bamlet WR, Crowson CS et al (2008) Incidence and risk factors of prosthetic joint infection after total hip or knee replacement in patients with rheumatoid arthritis. Arthritis Rheum 59:1713–1720CrossRef Bongartz T, Halligan CS, Osmon DR, Reinalda MS, Bamlet WR, Crowson CS et al (2008) Incidence and risk factors of prosthetic joint infection after total hip or knee replacement in patients with rheumatoid arthritis. Arthritis Rheum 59:1713–1720CrossRef
16.
go back to reference Van Kasteren ME, Manneien J, Ott A, Kullberg BJ, de Boer AS, Gyssens IC (2007) Antibiotic prophylaxis and the risk of surgical site infections following total hip arthroplasty: timely administration is the most important factor. Clin Infect Dis 44:921–927CrossRef Van Kasteren ME, Manneien J, Ott A, Kullberg BJ, de Boer AS, Gyssens IC (2007) Antibiotic prophylaxis and the risk of surgical site infections following total hip arthroplasty: timely administration is the most important factor. Clin Infect Dis 44:921–927CrossRef
17.
go back to reference Willis BW, Sheppard ED, Smith WR, Staggers JR, Li P, Shah A, Lee SR, Naranje SM (2018) Impact of operation time on early joint infection and deep vein thrombosis in primary total hip arthroplasty. Orthop Traumatol: Surg Res 104:445–448 Willis BW, Sheppard ED, Smith WR, Staggers JR, Li P, Shah A, Lee SR, Naranje SM (2018) Impact of operation time on early joint infection and deep vein thrombosis in primary total hip arthroplasty. Orthop Traumatol: Surg Res 104:445–448
19.
go back to reference Dicks KV, Baker AW, Durkin MJ, Anderson DJ, Moehring RW, Chen LF et al (2015) Short operative duration and surgical site infection risk in hip and knee arthroplasty procedures. Infect Control Hosp Epidemiol 36:1431–1436CrossRef Dicks KV, Baker AW, Durkin MJ, Anderson DJ, Moehring RW, Chen LF et al (2015) Short operative duration and surgical site infection risk in hip and knee arthroplasty procedures. Infect Control Hosp Epidemiol 36:1431–1436CrossRef
21.
go back to reference Tornero E, García-Oltra E, García-Ramiro S, Martínez-Pastor JC, Bosch J, Climent C, Morata L, Camacho P, Mensa J, Soriano A (2012) Prosthetic joint infections due to Staphyloccocus aureus and coagulase-negative staphylococci. Int J Artif Organs 35:884–892CrossRef Tornero E, García-Oltra E, García-Ramiro S, Martínez-Pastor JC, Bosch J, Climent C, Morata L, Camacho P, Mensa J, Soriano A (2012) Prosthetic joint infections due to Staphyloccocus aureus and coagulase-negative staphylococci. Int J Artif Organs 35:884–892CrossRef
22.
go back to reference Trickey AW, Wright JM, Donovan J, Reines HD, Dort JM, Prentice HA, Graling PR, Moynihan JJ (2017) Interrater reliability of hospital readmission evaluations for surgical patients. Am J Med Qual 32:201–207CrossRef Trickey AW, Wright JM, Donovan J, Reines HD, Dort JM, Prentice HA, Graling PR, Moynihan JJ (2017) Interrater reliability of hospital readmission evaluations for surgical patients. Am J Med Qual 32:201–207CrossRef
23.
go back to reference Sasaki K, Miura H, Takasugi S, Jingushi S, Suenaga E, Iwamoto Y (2009) Venous hemodynamic alterations in lower limbs undergoing total joint arthroplasty. Am J Orthop 38:137–140 Sasaki K, Miura H, Takasugi S, Jingushi S, Suenaga E, Iwamoto Y (2009) Venous hemodynamic alterations in lower limbs undergoing total joint arthroplasty. Am J Orthop 38:137–140
24.
go back to reference Florescu SC, Anastase DM, Munteanu AM, Stoica IC, Antonescu D (2013) Venous thromboembolism following major orthopedic surgery. Maedica (Buchar) 8(2):189–194 Florescu SC, Anastase DM, Munteanu AM, Stoica IC, Antonescu D (2013) Venous thromboembolism following major orthopedic surgery. Maedica (Buchar) 8(2):189–194
25.
go back to reference Memtsoudis SG, Besculides MC, Gaber L, Liu S, Della Valle AG (2009) Risk factors for pulmonary embolism after hip and knee arthroplasty: a population-based study. Int Orthop 33(6):1739–1745CrossRef Memtsoudis SG, Besculides MC, Gaber L, Liu S, Della Valle AG (2009) Risk factors for pulmonary embolism after hip and knee arthroplasty: a population-based study. Int Orthop 33(6):1739–1745CrossRef
26.
go back to reference Phan K, Kim JS, Capua JD, Lee NJ, Kothari P, Dowdell J, Overley SC, Guzman JZ, Cho SK (2017) Impact of operation time on 30-day complications after adult spinal deformity surgery. Global Spine J 7:664–671CrossRef Phan K, Kim JS, Capua JD, Lee NJ, Kothari P, Dowdell J, Overley SC, Guzman JZ, Cho SK (2017) Impact of operation time on 30-day complications after adult spinal deformity surgery. Global Spine J 7:664–671CrossRef
Metadata
Title
Operative time greater than 120 minutes is associated with increased pulmonary and thromboembolic complications following revision total hip arthroplasty
Authors
Alex Gu
Chapman Wei
Aaron Z. Chen
Michael-Alexander Malahias
Safa C. Fassihi
Michael P. Ast
Jiabin Liu
Michael B. Cross
Peter K. Sculco
Publication date
01-12-2020
Publisher
Springer Paris
Keywords
Hip-TEP
Hip-TEP
Published in
European Journal of Orthopaedic Surgery & Traumatology / Issue 8/2020
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-020-02712-4

Other articles of this Issue 8/2020

European Journal of Orthopaedic Surgery & Traumatology 8/2020 Go to the issue