title: Mortality and fatal pulmonary embolism after primary total hip replacement. Results from a regional hip register.
abstract: We calculated the rates for perioperative mortality and fatal pulmonary embolism (PE) after primary total hip replacement in a single UK health region, using a regional arthroplasty register and the tracing service of the Office of National Statistics. During 1990, there were 2111 consecutive primary replacements in 2090 separate procedures. Within 42 days of operation a total of 19 patients had died (0.91%, 95% CI 0.55 to 1.42). Postmortem examination showed that four deaths (0.19%, 95% CI 0.05 to 0.49) were definitely due to PE. The overall perioperative mortality and fatal PE rates are low and in our study did not appear to be altered by the use of chemical thromboprophylaxis (perioperative mortality rate: one-tailed Fisher's exact test, p = 0.39; fatal PE rate: one-tailed Fisher's exact test, p = 0.56). The routine use of chemical thromboprophylaxis for primary THR is still controversial. The issue should be addressed by an appropriate randomised, prospective study using overall mortality and fatal PE rate as the main outcome measures, but the feasibility of such a study is questioned.
authors.affiliation: University of Leicester, England, UK.
authors.forename: D
authors.initials: D
authors.lastname: Fender
authors.forename: W M
authors.initials: WM
authors.lastname: Harper
authors.forename: J R
authors.initials: JR
authors.lastname: Thompson
authors.forename: P J
authors.initials: PJ
authors.lastname: Gregg
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000401:mortality*; D002391:Catchment Area, Health / Q000706:statistics & numerical data; D018890:Chemoprevention; D015331:Cohort Studies; D004739:England / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000401:mortality*; D016032:Randomized Controlled Trials as Topic; D012042:Registries; D012307:Risk Factors; D013927:Thrombosis / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D006493:Heparin