High volume revision THA centers associated with lower in-hospital mortality rate

December 27, 2021

1 min read

Disclosures: Samuel does not report any relevant financial disclosure. Please see the study for relevant financial information from all other authors.

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Revision septic total hip arthroplasty was associated with a lower risk of in-hospital mortality when performed in a high-volume revision center compared to a low-volume revision center, according to a study published in Orthopedics.

“We found an in-hospital mortality rate of 5.2% at a 2-year follow-up period for patients undergoing septic THA revision, with low-volume hospitals having significantly higher mortality rates.” Linsen T. Samuel, MD, MBA, and his colleagues wrote.

Samuel and his colleagues used inpatient databases from the Healthcare Cost and Utilization Project of New York and Florida to identify 3,970 cases of septic revision PTH (rTHA) from 2007 to 2012. The researchers also analyzed a cohort matched of 257,420 patients who underwent primary THA and a cohort of 23,490 patients who underwent aseptic THA.

Outcomes were measured after a 2-year follow-up and included in-hospital mortality rate, effect of in-hospital hip revision surgery (HRV) volume on mortality, and independent risk factors. associated with hospital mortality.

Overall, 5.2% of patients who underwent septic THA, 2.9% who underwent primary THA, and 2.1% who underwent aseptic THA died.

Samuel and colleagues found that patients who underwent THA in an elevated HRV hospital had a statistically significantly lower odds ratio of in-hospital mortality (adjusted OR = 0.539; 95% CI: 0.332-0, 87) compared to patients who underwent THA at a low -Hospital HRV (P = .0127). In addition, they found that older age and greater comorbid burden were both independently associated with increased postoperative mortality at 2 years.

“Future studies should explore methods to reduce the risk of mortality, particularly for patients undergoing septic rTHA in hospitals with low HRV, with further analysis of adding complex orthopedic procedures to volume-outcome recommendations. “wrote Samuel and his colleagues. “Additionally, we recommend prioritizing high HRV centers for septic rTHA and using risk stratification when reporting in-hospital mortality rates after septic rTHA. “

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