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BMC Musculoskeletal Disorders

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Open Access 01-12-2021 | Pulmonary Edema | Research

Impact of valvular heart disease on hip replacement: a retrospective nationwide inpatient sample database study

Authors: Qiang Lian, Jian Wang, Yun Lian, Qinfeng Yang, Mingchen Zhao, Yang Zhang

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

Background

To study the impact of valvular heart disease (VHD) on hip replacement, particularly the clinical impactions of aortic stenosis before total/partial hip arthroplasty.

Methods

This was a retrospective cohort study. Data on patients who had undergone hip replacement from 2005 to 2014 were extracted from the NIS database. Independent t test and chi-square test were used to analyze the essential characteristics of patients. Multivariate regression was used to estimate the correlation among demographics, comorbidities, complications, hospitalization costs, and time.

Results

VHD accounted for 5.56% and AS accounted for 0.03% of the patients before hip replacement surgeries. Patients with VHD before hip replacement are related to the following characteristics: female patients (odds ratio [OR] = 1.15 [1.12–1.18]), elective admission (OR = 0.78 [0.76–0.80]), Charlson Comorbidity Index ≥3 (OR = 1.06 [1.03–1.08]), large-volume hospitals (OR = 1.13 [1.1–1.2]), teaching hospitals (OR = 5 4.4 [2.9–6.7]), and hospital location in urban areas (OR = 1.22 [1.2–1.3]). In addition, VHD is a risk factor for mortality and some acute postoperative medical complications, such as acute cardiac event (OR = 2.96 [2.87–3.04]), acute pulmonary edema (OR = 1.13 [1.06–1.21]), acute cerebrovascular event (OR = 1.22 [1.16–1.74]), and acute renal failure (OR = 1.22 [1.17–1.27]). It also has an impact on DVT/PE (OR = 0.89 [0.8–0.99]). Patients with AS before hip replacement have basic demographic characteristics like those of hip replacement patients with valvular disease. Patients with AS are older than those without AS before surgery (OR = 3.28 [2.27–4.75) and are related to the following characteristics: female patients (OR = 1.92 [1.32–2.8]) and elective admission (OR = 0.51 [0.36–0.75]). The perioperative period is limited to acute postoperative complications, such as acute cardiac events (OR = 2.50 [1.76–3.53]) and acute hepatic failure (OR = 7.69 [1.8–32.89]). Both valvular diseases and AS are associated with a higher mortality rate and hospitalization cost.

Conclusion

VHD independently predicted mortality rate and surgical and medical complications after total/partial hip arthroplasty.

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Title: Impact of valvular heart disease on hip replacement: a retrospective nationwide inpatient sample database study
Authors: Qiang Lian
Jian Wang
Yun Lian
Qinfeng Yang
Mingchen Zhao
Yang Zhang
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Pulmonary Edema
Acute Liver Failure
Valvular Heart Disease
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-021-04738-z

At a glance: The STEP trials

Springer Medicine

Impact of valvular heart disease on hip replacement: a retrospective nationwide inpatient sample database study

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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