The risk analysis of perioperative complications of cementless hip arthroplasty in octogenarians

Introduction Hip arthroplasty is exposed to demographic change as patients age. Analysis of risk factors for surgical treatment decisions in the group of ≥ 80-year-old patients is crucial. Healthcare systems in developed countries are being tested medically and financially by the ageing population. Therefore, this study analysed the perioperative complications of cementless primary hip arthroplasty in octogenarians and compared them with patients aged ≤ 60 years. Methods A retrospective data analysis of the year 2017 was done in a maximum care hospital of General Orthopaedic Surgery. Patients aged ≥ 80 years or ≤ 60 years with primary cementless hip arthroplasty were included. The outcome of interest was surgery-related and systemic complications, the development of haemoglobin and the incidence of blood transfusion after cementless primary hip arthroplasty in octogenarians during the hospitalisation and the follow-up treatment. Chi-square tests and Fischer's exact test were used for nominal variables. The two-factorial variance analysis-mixed model was used for Hb analyses and the Welch test for group comparison for metric parameters. Results There was a significantly increased incidence of systemic complications during hospitalisation in the ≥ 80-year-old patients (phi 0.26; Std. Ri − 0.8 (A), 2.2 (B); p = 0.007), as well as a significantly increased rate of blood transfusions (phi 0.403; Std. Ri − 1.3 (A), 3.2 (B); p = < 0.001). No clustered pre-existing conditions in the ≥ 80-year-old patients pointed out a significant association with the incidence of systemic complications. Surgery-related complications showed no significant difference during hospitalisation and follow-up treatment. Conclusion The study reveals that primary cementless hip prosthesis implantation is a safe procedure without increased incidence of surgery-related complications. Increased attention should be paid to interdisciplinary preoperative optimisation (adjustment of blood pressure, blood transfusions, if necessary, safe exclusion of urinary tract infections) and postoperative care of octogenarians (tight laboratory examinations, geriatric co-attendance)..

Medienart:	E-Artikel

Erscheinungsjahr:	2022
Erschienen:	2022

Enthalten in:	Zur Gesamtaufnahme - volume:143
Enthalten in:	Archives of orthopaedic and trauma surgery - 143(2022), 6 vom: 26. Aug., Seite 3551-3559

Sprache:	Englisch

Beteiligte Personen:	Koettnitz, Julian [VerfasserIn] Jäcker, Justus [VerfasserIn] Migliorini, Filippo [VerfasserIn] Trost, Michael [VerfasserIn] Peterlein, Christian Dominik [VerfasserIn] Götze, Christian [VerfasserIn]

Links:	Volltext [kostenfrei]

Themen:	Blood transfusion Cementless hip arthroplasty Hospitalisation Octogenarians Systemic complications

Anmerkungen:	© The Author(s) 2022

doi:	10.1007/s00402-022-04575-2

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	SPR05246542X