Skip to main content
Top
Published in: Clinical Orthopaedics and Related Research® 9/2010

Open Access 01-09-2010 | Symposium: Complications of Hip Arthroplasty

Factors That Predict Short-term Complication Rates After Total Hip Arthroplasty

Authors: Nelson F. SooHoo, MD, Eugene Farng, MD, Jay R. Lieberman, MD, Lauchlan Chambers, MD, David S. Zingmond, MD, PhD

Published in: Clinical Orthopaedics and Related Research® | Issue 9/2010

Login to get access

Abstract

Background

There remains uncertainty regarding the relative importance of patient factors such as comorbidity and provider factors such as hospital volume in predicting complication rates after total hip arthroplasty (THA).

Purpose

We therefore identified patient and provider factors predicting complications after THA.

Methods

We reviewed discharge data from 138,399 patients undergoing primary THA in California from 1995 to 2005. The rate of complications during the first 90 days postoperatively (mortality, infection, dislocation, revision, perioperative fracture, neurologic injury, and thromboembolic disease) was regressed against a variety of independent variables, including patient factors (age, gender, race/ethnicity, income, Charlson comorbidity score) and provider variables (hospital volume, teaching status, rural location).

Results

Compared with patients treated at high-volume hospitals (above the 20th percentile), patients treated at low-volume hospitals (below the 60th percentile) had a higher aggregate risk of having short-term complications (odds ratio, 2.00). A variety of patient factors also had associations with an increased risk of complications: increased Charlson comorbidity score, diabetes, rheumatoid arthritis, advanced age, male gender, and black race. Hispanic and Asian patients had lower risks of complications.

Conclusions

Patient and provider characteristics affected the risk of a short-term complication after THA. These results may be useful for educating patients and anticipating perioperative risks of THA in different patient populations.

Level of Evidence

Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Appendix
Available only for authorised users
Literature
1.
go back to reference Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992;45:613–619.CrossRefPubMed Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992;45:613–619.CrossRefPubMed
4.
go back to reference Katz JN, Losina E, Barrett J, Phillips CB, Mahomed NN, Lew RA, Guadagnoli E, Harris WH, Poss R, Baron JA. Association between hospital and surgeon procedure volume and outcomes of total hip replacement in the United States medicare population. J Bone Joint Surg Am. 2001;83:1622–1629.CrossRefPubMed Katz JN, Losina E, Barrett J, Phillips CB, Mahomed NN, Lew RA, Guadagnoli E, Harris WH, Poss R, Baron JA. Association between hospital and surgeon procedure volume and outcomes of total hip replacement in the United States medicare population. J Bone Joint Surg Am. 2001;83:1622–1629.CrossRefPubMed
5.
go back to reference Katz JN, Phillips CB, Baron JA, Fossel AH, Mahomed NN, Barrett J, Lingard EA, Harris WH, Poss R, Lew RA, Guadagnoli E, Wright EA, Losina E. Association of hospital and surgeon volume of total hip replacement with functional status and satisfaction three years following surgery. Arthritis Rheum. 2003;48:560–568.CrossRefPubMed Katz JN, Phillips CB, Baron JA, Fossel AH, Mahomed NN, Barrett J, Lingard EA, Harris WH, Poss R, Lew RA, Guadagnoli E, Wright EA, Losina E. Association of hospital and surgeon volume of total hip replacement with functional status and satisfaction three years following surgery. Arthritis Rheum. 2003;48:560–568.CrossRefPubMed
6.
go back to reference Mahomed NN, Barrett JA, Katz JN, Phillips CB, Losina E, Lew RA, Guadagnoli E, Harris WH, Poss R, Baron JA. Rates and outcomes of primary and revision total hip replacement in the United States Medicare population. J Bone Joint Surg Am. 2003;85:27–32.PubMed Mahomed NN, Barrett JA, Katz JN, Phillips CB, Losina E, Lew RA, Guadagnoli E, Harris WH, Poss R, Baron JA. Rates and outcomes of primary and revision total hip replacement in the United States Medicare population. J Bone Joint Surg Am. 2003;85:27–32.PubMed
8.
go back to reference Puolakka TJ, Pajamaki KJ, Halonen PJ, Pulkkinen PO, Paavolainen P, Nevalainen JK. The Finnish Arthroplasty Register: report of the hip register. Acta Orthop Scand. 2001;72:433–441.CrossRefPubMed Puolakka TJ, Pajamaki KJ, Halonen PJ, Pulkkinen PO, Paavolainen P, Nevalainen JK. The Finnish Arthroplasty Register: report of the hip register. Acta Orthop Scand. 2001;72:433–441.CrossRefPubMed
9.
go back to reference Quan H, Parsons GA, Ghali WA. Validity of information on comorbidity derived rom ICD-9-CCM administrative data. Med Care. 2002;40:675–685.CrossRefPubMed Quan H, Parsons GA, Ghali WA. Validity of information on comorbidity derived rom ICD-9-CCM administrative data. Med Care. 2002;40:675–685.CrossRefPubMed
10.
go back to reference Shervin N, Rubash HE, Katz JN. Orthopaedic procedure volume and patient outcomes: a systematic literature review. Clin Orthop Relat Res. 2007;457:35–41.CrossRefPubMed Shervin N, Rubash HE, Katz JN. Orthopaedic procedure volume and patient outcomes: a systematic literature review. Clin Orthop Relat Res. 2007;457:35–41.CrossRefPubMed
11.
go back to reference SooHoo NF, Lieberman JR, Ko CY, Zingmond DS. Factors predicting complication rates following total knee replacement. J Bone Joint Surg Am. 2006;88:480–485.CrossRefPubMed SooHoo NF, Lieberman JR, Ko CY, Zingmond DS. Factors predicting complication rates following total knee replacement. J Bone Joint Surg Am. 2006;88:480–485.CrossRefPubMed
12.
go back to reference Soohoo NF, Zingmond DS, Lieberman JR, Ko CY. Primary total knee arthroplasty in California 1991 to 2001: does hospital volume affect outcomes? J Arthroplasty. 2006;21:199–205.CrossRefPubMed Soohoo NF, Zingmond DS, Lieberman JR, Ko CY. Primary total knee arthroplasty in California 1991 to 2001: does hospital volume affect outcomes? J Arthroplasty. 2006;21:199–205.CrossRefPubMed
13.
go back to reference Zingmond DS, Ye Z, Ettner SL, Liu H. Linking hospital discharge and death records–accuracy and sources of bias. J Clin Epidemiol. 2004;57:21–29.CrossRefPubMed Zingmond DS, Ye Z, Ettner SL, Liu H. Linking hospital discharge and death records–accuracy and sources of bias. J Clin Epidemiol. 2004;57:21–29.CrossRefPubMed
Metadata
Title
Factors That Predict Short-term Complication Rates After Total Hip Arthroplasty
Authors
Nelson F. SooHoo, MD
Eugene Farng, MD
Jay R. Lieberman, MD
Lauchlan Chambers, MD
David S. Zingmond, MD, PhD
Publication date
01-09-2010
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 9/2010
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-010-1354-0

Other articles of this Issue 9/2010

Clinical Orthopaedics and Related Research® 9/2010 Go to the issue