Change in the cause of inpatient mortality after arthroplasty: a retrospective study
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(2019) 14:180
RESEARCH ARTICLE
Open Access
Change in the cause of inpatient mortality after arthroplasty: a retrospective study Yuzhi Zuo, Jin Lin, Jin Jin, Wenwei Qian, Guixing Qiu and Xisheng Weng*
Abstract Background: Although arthroplasty has been proved to be a safe and effective procedure, data regarding inpatient mortality rates associated with arthroplasty in China is unclear. We aimed to investigate the inpatient mortality rate after arthroplasty and the determinants of mortality at our center to ensure improved perioperative management. Methods: This retrospective study included all patients who underwent arthroplasty at our center. Clinical data of mortality patients were collected. The incidence and the causes of inpatient mortality after arthroplasty were analyzed. Results: A total of 4176 total knee arthroplasties, 2164 total hip arthroplasties, and 1031 femoral head replacements were performed. A rapid growth in surgery volume was observed, and more than 50% of the surgeries were performed in the last 5 years. The overall inpatient mortality rate is 0.3%; however, the mortality rate even decreased in the last 5 years. The cause of death changed over time. Pneumonia has become the leading cause of death in the past 5 years instead of cardiovascular complications. Conclusions: Arthroplasty is a safe and effective procedure associated with a relatively low inpatient mortality in China. And inpatient mortality does not increase as the growing surgery volume due to improvement of perioperative management. However, patients presenting with risk factors and those undergoing non-elective procedures demonstrated a relatively high incidence of postoperative complications, particularly pneumonia. Keywords: Joint arthroplasty, Inpatient mortality, Pneumonia, Cardiovascular disease
Background Arthroplasty including total hip/knee arthroplasty (THA/TKA) and femoral head replacement (FHR) is safe and effective to treat patients with arthropathy like severe osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis, as well as patients presenting with femoral neck fracture. It can significantly relieve the joint pain, restore the joint function, and improve the quality of life [1]. Over the last few decades, advances in surgical technology, prosthetic materials, enhanced recovery therapy strategy, and perioperative management have led to a significant reduction in surgical mortality rates. Owing to advances in the medical field and a rapidly growing aging population, indications of the arthroplasty have broadened. As older patients and those with more comorbidities are undergoing arthroplasties [2], the postoperative complications especially mortality rate * Correspondence: [email protected] Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Beijing 100730, China
remains a serious concern. Reportedly, the inpatient, the 30-day, and the 90- day mortality rates after elective TKA are 0.09–0.13%, 0
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