INCIDENCE RATES OF DISLOCATION, PULMONARY EMBOLISM, AND DEEP INFECTION DURING THE FIRST SIX MONTHS AFTER ELECTIVE TOTAL HIP REPLACEMENT

作者：Charlotte B. Phillips, JANE A. BARRETT, ELENA LOSINA, Nizar N. Mahomed, Elizabeth A. Lingard, Edward Guadagnoli, JOHN A. BARON, William Hamilton Harris, Robert Poss, Jeffrey Neil Katz · 发表于：Journal of Bone and Joint Surgery · 年份：2003 · DOI：10.2106/00004623-200301000-00004 · 被引用次数：503 · 研究领域：Total Knee Arthroplasty Outcomes、Orthopaedic implants and arthroplasty、Hip and Femur Fractures

BACKGROUND: The lengths of acute hospital stays following total hip replacement have diminished substantially in recent years. As a result, a greater proportion of complications occurs following discharge. Data on the incidence trends of major complications of total hip replacement would facilitate recognition and management of these adverse events. METHODS: We used Medicare claims data on beneficiaries sixty-five years and older who had had elective, primary total hip replacement for a reason other than a fracture (58,521 patients) or had had revision total hip replacement (12,956 patients) between July 1, 1995, and June 30, 1996. We calculated incidence rates of dislocation, pulmonary embolism, and deep hip infection per 10,000 person-weeks for four time-periods following the admission for the surgery (during the index hospitalization, from discharge to four weeks postoperatively, from five to thirteen weeks postoperatively, and from fourteen to twenty-six weeks postoperatively). We then used life-table methods to estimate the cumulative incidence of each complication over the first six postoperative months. RESULTS: Of the patients who had had a primary total hip replacement, 3.9% had a dislocation, 0.9% had a pulmonary embolism, and 0.2% had a deep infection in the first twenty-six postoperative weeks. In the revision total hip replacement cohort, the proportions with dislocation, pulmonary embolism, and deep infection were 14.4%, 0.8%, and 1.1%, respectively. The rates o...