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Abstract：
BACKGROUND: Hip hemiarthroplasty (HHA) is one of the most common types of orthopedic surgery. With the prevalence and utilization of the surgery increasing year after year, this procedure is found to be associated with severe postoperative complications and eventually mortality. Thus, it is crucial to understand the factors that increase the risk of mortality following HHA.
METHODS: Using the Nationwide Inpatient Sample (NIS) database, patients undergoing HHA from 2016 to 2019 were identified. This sample was stratified into a mortality group and a control group. The data regarding patients\' demographics, co-morbidities, and associated complications were compared between the groups.
RESULTS: Of the 84,067 patients who underwent the HHA procedures, 1,327 (1.6%) patients died. Additionally, the mortality group had a higher percentage of patients who were non-electively admitted (P < 0.001) and diabetic patients with complications (P < 0.001), but lower incidences of tobacco-related disorders (P < 0.001). Significant differences were also seen in age (P < 0.001), length of stay (P < 0.001), and total charges (P < 0.001) between the two groups. Preoperatively, those aged > 70 years (OR: 2.11, 95% CI [1.74, 2.56], P < 0.001) had diabetes without complications (OR: 0.32, 95% CI [0.23, 0.44], P < 0.001), tobacco-related disorders (OR: 0.24, 95% CI [0.17, 0.34], P < 0.001) and increased rates of mortality after HHA. Postoperatively, conditions, such as pulmonary embolisms (OR: 6.62, 95% CI [5.07, 8.65], P < 0.001), acute renal failure (OR: 4.58 95% CI [4.09, 5.13], P < 0.001), pneumonia (95% CI [2.72, 3.83], P < 0.001), and myocardial infarctions (OR: 2.65, 95% CI [1.80, 3.92], P < 0.001) increased likelihood of death after undergoing HHA. Patients who were electively admitted (OR: 0.46 95% CI [0.35, 0.61], P < 0.001) had preoperative obesity (OR: 0.67, 95% CI [0.44, 0.84], P = 0.002), and a periprosthetic dislocation (OR: 0.51, 95% CI [0.31, 0.83], P = 0.007) and were found to have a decreased risk of mortality following THA.
CONCLUSIONS: Analysis of pre- and postoperative complications relating to HHA revealed that several comorbidities and postoperative complications increased the odds of mortality. Old age, pulmonary embolisms, acute renal failure, pneumonia, and myocardial infraction enhanced the odds of post-HHA mortality.
METHODS: Using the Nationwide Inpatient Sample (NIS) database, patients undergoing HHA from 2016 to 2019 were identified. This sample was stratified into a mortality group and a control group. The data regarding patients\' demographics, co-morbidities, and associated complications were compared between the groups.
RESULTS: Of the 84,067 patients who underwent the HHA procedures, 1,327 (1.6%) patients died. Additionally, the mortality group had a higher percentage of patients who were non-electively admitted (P < 0.001) and diabetic patients with complications (P < 0.001), but lower incidences of tobacco-related disorders (P < 0.001). Significant differences were also seen in age (P < 0.001), length of stay (P < 0.001), and total charges (P < 0.001) between the two groups. Preoperatively, those aged > 70 years (OR: 2.11, 95% CI [1.74, 2.56], P < 0.001) had diabetes without complications (OR: 0.32, 95% CI [0.23, 0.44], P < 0.001), tobacco-related disorders (OR: 0.24, 95% CI [0.17, 0.34], P < 0.001) and increased rates of mortality after HHA. Postoperatively, conditions, such as pulmonary embolisms (OR: 6.62, 95% CI [5.07, 8.65], P < 0.001), acute renal failure (OR: 4.58 95% CI [4.09, 5.13], P < 0.001), pneumonia (95% CI [2.72, 3.83], P < 0.001), and myocardial infarctions (OR: 2.65, 95% CI [1.80, 3.92], P < 0.001) increased likelihood of death after undergoing HHA. Patients who were electively admitted (OR: 0.46 95% CI [0.35, 0.61], P < 0.001) had preoperative obesity (OR: 0.67, 95% CI [0.44, 0.84], P = 0.002), and a periprosthetic dislocation (OR: 0.51, 95% CI [0.31, 0.83], P = 0.007) and were found to have a decreased risk of mortality following THA.
CONCLUSIONS: Analysis of pre- and postoperative complications relating to HHA revealed that several comorbidities and postoperative complications increased the odds of mortality. Old age, pulmonary embolisms, acute renal failure, pneumonia, and myocardial infraction enhanced the odds of post-HHA mortality.
摘要：
背景：髋关节置换术（HHA）是最常见的骨科手术类型之一。随着手术的患病率和使用率逐年上升,发现该手术与严重的术后并发症和最终死亡相关.因此，了解增加HHA后死亡风险的因素至关重要.
方法：使用全国住院患者样本（NIS）数据库，确定了2016年至2019年接受HHA的患者.将该样本分层为死亡组和对照组。关于患者人口统计学的数据，合并症,比较各组间的相关并发症。
结果：在接受HHA手术的84,067名患者中，1,327（1.6％）患者死亡。此外,死亡组的非选择性住院患者（P<0.001）和有并发症的糖尿病患者（P<0.001）的比例更高，但烟草相关疾病的发病率较低(P<0.001)。年龄也有显著差异(P<0.001)。住院时间（P<0.001），两组之间的总收费（P<0.001）。术前,年龄>70岁的人(OR：2.11，95%CI[1.74，2.56]，P<0.001)有糖尿病无并发症(OR:0.32,95%CI[0.23,0.44],P<0.001)，烟草相关疾病(OR：0.24，95%CI[0.17，0.34]，P<0.001），HHA后死亡率增加。术后,条件,如肺栓塞(OR：6.62，95%CI[5.07，8.65]，P<0.001)，急性肾功能衰竭（OR：4.5895%CI[4.09，5.13]，P<0.001)，肺炎（95%CI[2.72，3.83]，P<0.001)，和心肌梗塞（OR：2.65，95%CI[1.80，3.92]，P<0.001）增加了接受HHA后死亡的可能性。选择性入院的患者(OR：0.4695%CI[0.35，0.61]，P<0.001)有术前肥胖(OR:0.67,95%CI[0.44,0.84],P=0.002),和假体周围脱位(OR：0.51，95%CI[0.31，0.83]，P=0.007），发现THA后死亡风险降低。
结论：对与HHA相关的术前和术后并发症的分析显示，一些合并症和术后并发症增加了死亡率。老年,肺栓塞,急性肾功能衰竭,肺炎,和心肌梗塞增加了HHA后死亡的几率。
方法：使用全国住院患者样本（NIS）数据库，确定了2016年至2019年接受HHA的患者.将该样本分层为死亡组和对照组。关于患者人口统计学的数据，合并症,比较各组间的相关并发症。
结果：在接受HHA手术的84,067名患者中，1,327（1.6％）患者死亡。此外,死亡组的非选择性住院患者（P<0.001）和有并发症的糖尿病患者（P<0.001）的比例更高，但烟草相关疾病的发病率较低(P<0.001)。年龄也有显著差异(P<0.001)。住院时间（P<0.001），两组之间的总收费（P<0.001）。术前,年龄>70岁的人(OR：2.11，95%CI[1.74，2.56]，P<0.001)有糖尿病无并发症(OR:0.32,95%CI[0.23,0.44],P<0.001)，烟草相关疾病(OR：0.24，95%CI[0.17，0.34]，P<0.001），HHA后死亡率增加。术后,条件,如肺栓塞(OR：6.62，95%CI[5.07，8.65]，P<0.001)，急性肾功能衰竭（OR：4.5895%CI[4.09，5.13]，P<0.001)，肺炎（95%CI[2.72，3.83]，P<0.001)，和心肌梗塞（OR：2.65，95%CI[1.80，3.92]，P<0.001）增加了接受HHA后死亡的可能性。选择性入院的患者(OR：0.4695%CI[0.35，0.61]，P<0.001)有术前肥胖(OR:0.67,95%CI[0.44,0.84],P=0.002),和假体周围脱位(OR：0.51，95%CI[0.31，0.83]，P=0.007），发现THA后死亡风险降低。
结论：对与HHA相关的术前和术后并发症的分析显示，一些合并症和术后并发症增加了死亡率。老年,肺栓塞,急性肾功能衰竭,肺炎,和心肌梗塞增加了HHA后死亡的几率。
