Risk Factors for Perioperative Mortality After Lower Extremity Arthroplasty: A Population-Based Study of 6,901,324 Patient Discharges☆
Section snippets
The National Hospital Discharge Survey
National Hospital Discharge Survey (NHDS) multiyear data files were obtained from the Centers of Disease Control and Prevention, Atlanta, GA. The plan and operation of the NHDS has been published in detail [6]. In summary, the NHDS includes medical information collected annually since 1965 by the National Center for Health Statistics with the purpose of compiling nationally representative data on in-patient utilization of short-stay hospitals. The hospital universe includes Medicare
Results
An estimated total of 6 901 324 (primary THA 33.16% and revision THA 6.47%; primary TKA 55.50% and revision TKA 4.91%) procedures were performed between 1990 and 2004. During this period, 23 931 (0.35%) patients died during their hospitalization (primary THA 0.32% and revision THA 0.98%; primary TKA 0.30% and revision TKA 0.27%).
Table 1 details patient and health care system–related characteristics of the entire patient population in comparison to those who died in the hospital after surgery.
Discussion
In this study, we were able to characterize the patient population who died during their hospitalization after THA and TKA surgery and compare them to those who had a nonfatal outcome. Furthermore, we identified preoperative and postoperative risk factors for in-hospital mortality. Using data collected over a 15-year period in a nationally representative database, we were able to avoid bias introduced by regional, institutional, and temporal factors.
The overall short-term mortality rate after
Acknowledgment
We would like to thank Ms Licia K. Gaber, BA (LKG Consulting, 24-07 Aspen Drive, Plainsboro, NJ) for her assistance with the writing of program codes.
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This study was funded by the Hospital for Special Surgery Anesthesiology Young Investigator Award provided by the Department of Anesthesiology and the Hospital for Special Surgery.