title: Avascular Necrosis Is Associated With Increased Transfusions and Readmission Following Primary Total Hip Arthroplasty.
abstract: Avascular necrosis (AVN) may confer an increased risk of complications and readmission following total hip arthroplasty (THA). However, current risk-adjustment models do not account for AVN. A total of 1706 patients who underwent THA for AVN from 2011 to 2013 were selected from the American College of Surgeon's National Surgical Quality Improvement Program database and matched 1:1 to controls using a predetermined propensity score algorithm. Rates of 30-day medical and surgical complications, readmissions, and reoperations were compared between cohorts. Propensity-score logistic regression was used to determine independent associations between AVN and outcomes of interest. Patients with AVN had a higher rate of medical complications than those without AVN (20.3% vs 15.3%, respectively; P<.001). Bleeding transfusion was the most common medical complication, occurring at a significantly higher rate in patients with AVN than those without AVN (19.6% vs 13.9%, respectively; P<.001). Patients with AVN were also twice as likely to experience a readmission after THA (odds ratio, 2.093; 95% confidence interval, 1.385-3.164). Avascular necrosis of the femoral head is an independent risk factor for transfusion up to 72 hours postoperatively and readmission up to 30 days following total hip replacement. [Orthopedics. 2017; 40(3):171-176.].
authors.forename: Francis C
authors.initials: FC
authors.lastname: Lovecchio
authors.forename: John Paul
authors.initials: JP
authors.lastname: Manalo
authors.forename: Alysen
authors.initials: A
authors.lastname: Demzik
authors.forename: Shawn
authors.initials: S
authors.lastname: Sahota
authors.forename: Matthew
authors.initials: M
authors.lastname: Beal
authors.forename: David
authors.initials: D
authors.lastname: Manning
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D009336:Necrosis / Q000175:diagnosis*; D016017:Odds Ratio; D019637:Orthopedic Procedures / Q000379:methods; D010020:Osteonecrosis / Q000209:etiology*; D010359:Patient Readmission; D017713:Platelet Transfusion; D012086:Reoperation / Q000706:statistics & numerical data*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome