title: Age as an independent risk factor for postoperative morbidity and mortality after total joint arthroplasty in patients 90 years of age or older.
abstract: The population of patients over 90 years of age has experienced the fastest growth in recent years. The number of primary total joint arthroplasties (TJA) has also been increasing. Our objectives were to examine in-hospital morbidity, mortality and resource consumption following primary TJA in patients older than 89 years at the national level. Nationwide Inpatient Sample was used to identify 8,340,167 patients who underwent TJA between 1993 and 2008, 58,355 (0.7%) were 90 years of age or older. Older patients were at higher risk of developing cardiac (OR 2.5; 95% CI 2.4-2.6), neurological (OR 2.1; 95% CI 1.8-2.4), respiratory complications and higher risk of mortality (OR 11.5; 95% CI 10.93-12.1) after controlling for baseline comorbidities. Age is an independent risk factor for postoperative complications and mortality. Our data can be used to educate patients on the risks before undergoing primary TJA and aid physicians in assessing and adjusting perioperative risk.
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia.
authors.forename: Michele R
authors.initials: MR
authors.lastname: D'Apuzzo
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Pao
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia.
authors.forename: Wendy M
authors.initials: WM
authors.lastname: Novicoff
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia.
authors.forename: James A
authors.initials: JA
authors.lastname: Browne
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000401:mortality / Q000706:statistics & numerical data*; D019645:Arthroplasty, Replacement, Knee / Q000401:mortality / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D012307:Risk Factors; D016896:Treatment Outcome
keywords: hip arthroplasty; knee arthroplasty; mortality; postoperative complications