PT  - JOURNAL ARTICLE
AU  - Rüdiger J.  Weiss
AU  - Göran Garellick
AU  - Johan Kärrholm
AU  - Nils P.  Hailer
TI  - Total Hip Arthroplasty in 6690 Patients with Inflammatory Arthritis: Effect of Medical Comorbidities and Age on Early Mortality
AID  - 10.3899/jrheum.151287
DP  - 2016 May 01
TA  - The Journal of Rheumatology
PG  - jrheum.151287
4099  - http://www.jrheum.org/content/early/2016/04/22/jrheum.151287.short
4100  - http://www.jrheum.org/content/early/2016/04/22/jrheum.151287.full
AB  - Objective We analyzed early mortality after total hip arthroplasty (THA) in patients with inflammatory arthritis (IA), adjusting for medical comorbidities and socioeconomic background. Methods Data on 6690 patients with IA who underwent THA during 1992–2012 were extracted from the Swedish Hip Arthroplasty Register. Data on comorbidity, measured using the Charlson Comorbidity Index (CCI), and socioeconomic data were gathered from the Swedish National Inpatient Register and Statistics Sweden. The CCI was divided into low (0), moderate (1–2), and high (> 2). Cox proportional hazards models were fitted to calculate adjusted HR of early mortality, with 95% CI. Results Twenty-five patients (0.4%) died within 0-90 days, giving a 90-day unadjusted survival rate of 99.6% (CI 99.5–99.8). Comorbidity was associated with an increased risk of death within 90 days postoperatively [high vs low CCI: adjusted HR 9.0 (CI 1.6–49.9)]. There was a trend toward lower risk of death during the period 1999–2005, although patients operated on during this period had more comorbidities than those operated on from 1992 to 1998. A large proportion of patients was re-admitted to hospital within 90 days after the index procedure (30.2%), but rarely for cardiovascular reasons. Conclusion Medical comorbidity and an age above 75 years are associated with a substantial increase in the risk of early death after THA in patients with IA. Awareness of potential risk factors may alert clinicians and thus improve perioperative care.