title: [Influence of Comorbidities on Revision Rate within the First Year after Primary Total Hip Arthroplasty].
abstract: BackgroundTotal hip arthroplasty (THA) is very frequently performed. Despite low complication rates, revisions play an important clinical and economical role. The aim of this study was to identify comorbid diseases of patients undergoing primary THA and their potential influence on the survival of hip replacements.Patients/Material and MethodsA total of 867 patients were included in this retrospective study. All revisions were reviewed that took place at our hospital within one year of primary implantation of THA. Comorbid diseases were detected by administrative data, using the Elixhauser definition, which includes thirty diseases. The Cox regression model and Fisher's exact test were used to examine correlations between comorbidities and risk of revision.Results41 Patients required re-operation within the first year of surgery. The presence of one or more of the analysed comorbidities was associated with a greater risk of revision. Deficiency anemia, obesity, drug abuse, alcohol abuse, fluid and electrolyte disorders and peripheral vascular disorders were associated with increased risk of revision (p < 0.05 for all comparisons).
  
  
  
  The total number of comorbidities and specific comorbid diseases was independently associated with an increased risk of re-operation within the first year of total hip arthroplasty. This information could be helpful in pre- and post-operative risk adjustment and patient selection.
authors.affiliation: Orthopädische Klinik im Diakovere Annastift, Medizinische Hochschule Hannover.
authors.forename: Roman
authors.initials: R
authors.lastname: Nesslage
authors.affiliation: Orthopädische Klinik im Diakovere Annastift, Medizinische Hochschule Hannover.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Radtke
authors.affiliation: Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Freiburg.
authors.forename: Lisa
authors.initials: L
authors.lastname: Hohloch
authors.affiliation: Orthopädische Klinik im Diakovere Annastift, Medizinische Hochschule Hannover.
authors.forename: Thilo
authors.initials: T
authors.lastname: Floerkemeier
authors.affiliation: Orthopädische Klinik im Diakovere Annastift, Medizinische Hochschule Hannover.
authors.forename: Henning
authors.initials: H
authors.lastname: Windhagen
authors.affiliation: Orthopädische Klinik im Diakovere Annastift, Medizinische Hochschule Hannover.
authors.forename: Gabriela von
authors.initials: GV
authors.lastname: Lewinski
mesh_terms: D000437:Alcoholism / Q000453:epidemiology; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology*; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data; D015984:Causality; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D015207:Osteoarthritis, Hip / Q000453:epidemiology* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D011475:Prosthesis Failure; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D016896:Treatment Outcome; D014600:Utilization Review; D014652:Vascular Diseases / Q000453:epidemiology; D014883:Water-Electrolyte Imbalance / Q000453:epidemiology