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Outcomes of Elective Total Hip Arthroplasty in Nonagenarians and Centenarians.

Authors :
Sherman AE
Plantz MA
Hardt KD
Source :
The Journal of arthroplasty [J Arthroplasty] 2020 Aug; Vol. 35 (8), pp. 2149-2154. Date of Electronic Publication: 2020 Mar 21.
Publication Year :
2020

Abstract

Background: Nonagenarians and centenarians are among the fastest growing demographics in the United States. Although consequent demand for joint replacement is projected to rise precipitously, outcomes of total hip arthroplasty (THA) have seldom been studied in this population.<br />Methods: A retrospective cohort of patients undergoing primary THA was established using the 2008-2017 American College of Surgeons National Quality Improvement Program. Propensity scores were used to match 858 patients aged 90 or older to 858 patients aged 65-89, controlling for demographic factors and comorbidities. Thirty-day outcomes were compared between matched age cohorts using multiple regression modeling.<br />Results: Statistically equivalent 30-day rates of surgical infection (P = .73), pneumonia (P = .39), deep venous thrombosis/thrombophlebitis (P = .55), pulmonary embolism (P = .69), stroke (P = .73), myocardial infarction (P = .44), cardiac arrest (P = .69), and sepsis (P = .77) were observed between matched age cohorts, although nonagenarians and centenarians were significantly more likely to experience urinary tract infection (2.8% vs 0.9%, P = .004). In addition, matched patients aged 90 or older were more likely to have longer hospital stays (3.52 vs 2.81 days, P < .001) and be discharged to a nonhome facility (75.4% vs 34.6%, P < .001) but were at no higher than 30-day risk of reoperation (P = .45), readmission (P = .23), or mortality (P = .59).<br />Conclusion: Overall, THA remains a safe and viable treatment modality beyond the ninth decade of life. Patient comorbidity profiles, rather than age, should principally guide shared clinical decision making.<br /> (Published by Elsevier Inc.)

Details

Language :
English
ISSN :
1532-8406
Volume :
35
Issue :
8
Database :
MEDLINE
Journal :
The Journal of arthroplasty
Publication Type :
Academic Journal
Accession number :
32312644
Full Text :
https://doi.org/10.1016/j.arth.2020.03.026