Mortality after septic versus aseptic revision total hip arthroplasty: a matched-cohort study.
Mortality rates after revision total hip arthroplasty (THA) for periprosthetic sepsis were investigated in 93 patients and compared to 93 patients, matched for age, gender, year of surgery, who underwent revision for aseptic failures. The mortality rate was 33% (31/93) in the septic group and 22% (20/93) in the aseptic group at 5 and 6 year follow-up, respectively (P=0.10). Patients in the septic group died on average 6 years earlier (74 versus 80 yrs; P<0.05) than those in the aseptic group. Charlson Comorbidity Index (CCI) was an independent predictor of mortality among the both groups (P<0.05), while age (P<0.01) was a predictor of mortality only in the aseptic group. While revision THA for sepsis alone did not predict increased mortality, a 33% mortality rate at five years in patients with an average age of 66 years and earlier death by 6 years compared to aseptic revisions is alarming.
Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, Massachusetts.
Ho-Rim
HR
Choi
Benjamin
B
Beecher
Hany
H
Bedair
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality*; D015995:Prevalence; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000401:mortality*; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology / Q000401:mortality*; D015996:Survival Rate
mortality; septic revision; total hip arthroplasty