[Factors influencing perioperative morbidity and mortality in primary hip arthroplasty].
BACKGROUND
In the present study we examined preoperative parameters that may identify patients at high risk for postoperative complications after endoprosthetic joint replacement.


METHODS
The incidence of risk factors and perioperative complications in 628 primary hip arthroplasties (THA) (549 patients) was investigated in an unselected, retrospective study. Concomitant illnesses were found in 426 cases. Intra- and postoperative complications (93 specifically orthopedic and 42 common ones) were observed in 104 cases.


RESULTS
High risk scores based on Lutz and Klose criteria, a prolonged operation time, and the number of previous operations were significantly correlated to the incidence of postoperative complications. In contrast, obese patients had a significantly lower rate of intra- and postoperative complications and a diminished perioperative blood loss. THAs performed under intubation anesthesia led to a higher blood transfusion volume. The patient's age and the kind and quantity of concomitant illnesses did not influence the perioperative complication rate.


CONCLUSIONS
The complication rate of elective primary THAs is not dependent on risk factors suspected up to now such as advanced patient age or the kind and quantity of concomitant illnesses. High-risk patients can only be determined by complex scores, not by single parameters. Adiposity becomes a relevant economic factor only by dint of the prolonged operation time.
Klinik für Orthopädie, Universitätsmedizin Berlin. carsten.perka@charite.de
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Paul
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Matziolis
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000401:mortality*; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006622:Hip Prosthesis / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000401:mortality*; D011183:Postoperative Complications / Q000401:mortality*; D015995:Prevalence; D011379:Prognosis; D016459:Prosthesis-Related Infections / Q000401:mortality*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome