Understanding the 30-day mortality burden after revision total hip arthroplasty

• Published in: Hip international 2023-07, Vol.33 (4), p.727-735
• Main Authors: Rullán, Pedro J, Orr, Melissa N, Emara, Ahmed K, Klika, Alison K, Molloy, Robert M, Piuzzi, Nicolas S
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip - statistics & numerical data; Female; Humans; Male; Middle Aged; Mortality; Prosthesis Failure - trends; Reoperation - statistics & numerical data; Retrospective Studies; Sepsis - mortality; Young Adult
• ISSN: 1120-7000; 1724-6067
• DOI: 10.1177/11207000221094543

Background: Revision total hip arthroplasty (THA) is a challenging procedure that burdens the healthcare system. Despite being associated with worse outcomes relative to its primary counterpart, postoperative mortality after revision THA remains ill-defined. The present study aimed to (1) establish the overall 30-day mortality rate after revision THA and (2) explore the mortality rate stratified by age, comorbidity burden, and aseptic versus septic failure. Methods: The American College of Surgeons – National Surgical Quality Improvement Program (ACS-NSQIP) database was retrospectively reviewed for all patients who underwent revision THA from 2011 to 2019. A total of 23,501 patients were identified and grouped into mortality (n = 161) and mortality-free (n = 23,340) cohorts. Patient demographics, comorbidities, and aseptic/septic failure were evaluated. Results: The overall 30-day mortality was 0.69%. The mortality rate by age group (normalised per 1000 patients) was 0 (18–39 years [Y]), 0.67 (40–49 Y), 1.10 (50–59 Y), 2.58 (60–69 Y), 6.15 (70–79 Y) 19.32 (80–89 Y), and 58.22 (90+Y) (p