Document Detail


Mortality following revision joint arthroplasty: is age a factor?
MedLine Citation:
PMID:  20954672     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
With the demand for total joint arthroplasty and overall life expectancy increasing, there will be an increase in the need for revision arthroplasty surgeries. Given that revision joint surgeries are more demanding for both surgeon and patient with longer operative times, increased blood loss, and multiple patient comorbidities, the current mindset is that older patients who undergo a total hip revision or total knee revision have higher mortality rates than younger patients. We identified 1737 revision total joint patients who were at least 2 years postoperative for inclusion in the study. The overall perioperative mortality rate (defined as deaths occurring between 0 and 3 months following revision joint surgery) was calculated and then stratified by revision knee surgery, revision hip surgery, and age. In addition, mortality rates were compared for patients younger than 70 years, between 70 and 80 years and older than 80 years. The overall perioperative mortality rate after revision total hip or knee surgery was 0.7%. After stratifying by age, the perioperative mortality rate was 0.2% in patients younger than 70 years, 0.8% in patients 70 to 79 years, and 2.63% in patients older than 80 years. Of the 1737 patients, 541 died >1 year following their revision surgery at an average time to death of 6.9 years. The observed perioperative mortality rates following revision total joint surgery at a single center were extremely low among all age groups. Therefore, the age of patients undergoing revision surgery should not be the sole determinant of perioperative survival. Additionally, it appears that the mean postoperative survival noted here seems to justify the additional resources used in revision surgery regardless of age. As limited resources exert pressure on an already overburdened healthcare system, rationing of care for certain procedures may ensue using age as a specific criteria. This study should add clarity to this issue.
Authors:
Thomas K Fehring; Susan M Odum; Keith Fehring; Bryan D Springer; William L Griffin; Anne C Dennos
Publication Detail:
Type:  Journal Article     Date:  2010-10-11
Journal Detail:
Title:  Orthopedics     Volume:  33     ISSN:  1938-2367     ISO Abbreviation:  Orthopedics     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806107     Medline TA:  Orthopedics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  715     Citation Subset:  IM    
Copyright Information:
Copyright 2010, SLACK Incorporated.
Affiliation:
OrthoCarolina Hip and Knee Center, Charlotte, North Carolina 28207, USA. thomas.fehring@ orthocarolina.com
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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