Incidence and risk factors associated with postoperative delirium following primary elective total hip arthroplasty: a retrospective nationwide inpatient sample database study

Abstract Background: Postoperative delirium is a common complication following major surgeries, leading to a variety of adverse effects. However, there is a paucity of literatures studying the incidence and risk factors of delirium after primary elective total hip arthroplasty (THA) using a large-scale national database. Methods: A retrospective database analysis was performed based on Nationwide Inpatient Sample (NIS) from 2009-2014. Patients who underwent primary elective THA were included. Patient demographics, comorbidities, length of hospital stay (LOS), total charges, in-hospital mortality, and major and minor perioperative complications were evaluated. Results: A total of 388,424 primary elective THAs were obtained from the NIS database, and the general incidence of delirium after THA was 0.90%. Patients with delirium after THA presented more comorbidities, increased LOS, extra hospital charges, and higher in-hospital mortality rate (P<0.001). Delirium following THA was associated with major complications during hospitalization including acute renal failure and pneumonia. Risk factors of postoperative delirium included advanced age, alcohol or drug abuse, depression, neurological disorders, psychoses, fluid and electrolyte disorders, diabetes, weight loss, deficiency anemia, coagulopathy, hypertension, congestive heart failure, valvular disease, pulmonary circulation disorders, peripheral vascular disorders, and renal failure. Both female and obesity were detected to be protective factors. Conclusions: The results of our study identified a relatively low incidence of delirium after primary elective THA. Postoperative delirium of THA was associated with increased comorbidities, LOS, total charges, in-hospital mortality, and major perioperative complications including acute renal failure and pneumonia. It is of benefit to study risk factors of postoperative delirium to moderate its consequences.

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Risk Factors Associated With Short-term Clinical Results After Total Hip Arthroplasty for Patients With Rheumatoid Arthritis

Orthopedics ◽

10.3928/01477447-20180828-06 ◽

2018 ◽

Vol 41 (6) ◽

pp. e772-e776 ◽

Cited By ~ 1

Author(s):

Takashi Imagama ◽

Atsunori Tokushige ◽

Kazushige Seki ◽

Toshihiro Seki ◽

Hiroyoshi Ogasa ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Clinical Results ◽

Short Term ◽

Factors Associated ◽

Total Hip

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Incidence and Risk Factors of Postoperative Delirium Following Primary Elective Total Hip Arthroplasty: A Retrospective Nationwide Inpatient Sample Database Study

10.21203/rs.3.rs-16891/v1 ◽

2020 ◽

Author(s):

Qinfeng Yang ◽

Jian Wang ◽

Xusheng Huang ◽

Yichuan Xu ◽

Yang Zhang

Keyword(s):

Risk Factors ◽

Renal Failure ◽

Acute Renal Failure ◽

Total Hip Arthroplasty ◽

Hospital Mortality ◽

Hip Arthroplasty ◽

Nationwide Inpatient Sample ◽

Postoperative Delirium ◽

Perioperative Complications ◽

Total Charges

Abstract Background Postoperative delirium is a common complication following major surgeries, leading to a variety of adverse effects. However, there is a paucity of literatures studying the incidence and risk factors of delirium after primary elective total hip arthroplasty (THA) using a large-scale national database. Methods A retrospective database analysis was performed based on Nationwide Inpatient Sample (NIS) from 2009-2014. Patients who underwent primary elective THA were included. Patient demographics, comorbidities, length of hospital stay (LOS), total charges, in-hospital mortality, and major and minor perioperative complications were evaluated. Results A total of 388,424 primary elective THAs were obtained from the NIS database, and the general incidence of delirium after THA was 0.90%. Patients with delirium after THA presented more comorbidities, increased LOS, extra hospital charges, and higher in-hospital mortality rate (P<0.001). Delirium following THA was associated with major complications during hospitalization including acute renal failure and pneumonia. Risk factors of postoperative delirium included advanced age, alcohol or drug abuse, depression, neurological disorders, psychoses, fluid and electrolyte disorders, diabetes, weight loss, deficiency anemia, coagulopathy, hypertension, congestive heart failure, valvular disease, pulmonary circulation disorders, peripheral vascular disorders, and renal failure. Both female and obesity were detected to be protective factors. Conclusions The results of our study identified a relatively low incidence of delirium after primary elective THA. Postoperative delirium of THA was associated with increased comorbidities, LOS, total charges, in-hospital mortality, and major perioperative complications including acute renal failure and pneumonia. It is of benefit to study risk factors of postoperative delirium to moderate its consequences.

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Risk Factors for Discharge to a Non-Home Destination and Reoperation Following Outpatient Total Hip Arthroplasty (THA) in Medicare-Eligible Patients

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151459321991500 ◽

2021 ◽

Vol 12 ◽

pp. 215145932199150

Author(s):

Adam M. Gordon ◽

Azeem Tariq Malik ◽

Safdar N. Khan

Keyword(s):

Risk Factors ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Care Facility ◽

Discharge Destination ◽

Improvement Program ◽

Factors Associated ◽

Total Hip ◽

Home Discharge ◽

Independent Risk Factors

Introduction: The Centers for Medicare and Medicaid Services removed total hip arthroplasty (THA) from the inpatient-only (IO) list in January 2020. Given this recommendation, we analyzed Medicare-eligible patients undergoing outpatient THA to understand risk factors for nonroutine discharge, reoperations, and readmissions. Materials and Methods: The 2015-2018 American College of Surgeons–National Surgical Quality Improvement Program database was queried using Current Procedural Terminology code 27130 for Medicare eligible patients (≥ 65 years of age) undergoing outpatient THA. Postoperative discharge destination was categorized into home and non-home. Multivariate logistic regression models were used to evaluate risk factors associated with non-home discharge disposition. Secondarily, we evaluated rates and risk factors associated with 30-day reoperations and readmissions. Results: A total of 1095 THAs were retrieved for final analysis. A total of 108 patients (9.9%) experienced a non-home discharge postoperatively. Patients were discharged to rehab (n = 47; 4.3%), a skilled care facility (n = 47; 4.3%), a facility that was “home” (n = 8; 0.7%), a separate acute care facility (n = 5; 0.5%), or an unskilled facility (n = 1; 0.1%). Independent factors for a non-home discharge were American Society of Anesthesiologists Class >II (odds ratio [OR] 2.74), operative time >80 minutes (OR 2.42), age >70 years (OR 2.20), and female gender (OR 1.67). Eighteen patients (1.6%) required an unplanned reoperation within 30 days. A total of 40 patients (3.7%) required 30-day readmissions, with 35 readmissions related to the original THA procedure. Independent risk factors for 30-day reoperation were COPD (OR 5.85) and HTN (OR 5.24). Independent risk factors for 30-day readmission were HTN (OR 4.35) and Age >70 (OR 2.48). Discussion: The current study identifies significant predictors associated with a non-home discharge, reoperation, and readmission in Medicare-aged patients undergoing outpatient THA. Conclusion: Providers should consider preoperatively risk-stratifying patients to reduce the costs associated with unplanned discharge destination, complication or reoperation.

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Risk Factors Associated With Early Complications of Revision Surgery for Head-Neck Taper Corrosion in Metal-on-Polyethylene Total Hip Arthroplasty

The Journal of Arthroplasty ◽

10.1016/j.arth.2018.05.046 ◽

2018 ◽

Vol 33 (10) ◽

pp. 3231-3237 ◽

Cited By ~ 12

Author(s):

Young-Min Kwon ◽

Daniel Rossi ◽

John MacAuliffe ◽

Yun Peng ◽

Paul Arauz

Keyword(s):

Risk Factors ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Revision Surgery ◽

Early Complications ◽

Factors Associated ◽

Total Hip ◽

Head Neck

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Epidemiological Study of Femoral Head Osteonecrosis

Revista de Chimie ◽

10.37358/rc.17.5.5593 ◽

2017 ◽

Vol 68 (5) ◽

pp. 974-976

Author(s):

Alexandru Patrascu ◽

Liliana Savin ◽

Dan Mihailescu ◽

Victor Grigorescu ◽

carmen Grierosu ◽

...

Keyword(s):

Risk Factors ◽

Femoral Head ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Young Patients ◽

Head Group ◽

Bipolar Hemiarthroplasty ◽

Aseptic Necrosis ◽

Total Hip ◽

Femoral Head Osteonecrosis

In recent years, there has been an increase in the number of studies on the etiology of femoral head necrosis. We retrospectively reviewed all patients diagnosed with aseptic necrosis of the femoral in the period of 2010-2015. We recorded a total of 230 cases diagnosed with aseptic necrosis of the femoral head, group was composed of 65.7% men and 34.3% women, risk factors identified was 19.13% (post-traumatic), 13.91% (glucocorticoids), 26.52% (alcohol), 3.47% (another cause) and in 36 95% of the cases no risk factors were found. The results of the study based on the type of surgery performed on the basis of stages of disease progression, 8 patients (3.48%) benefited from osteotomy, 28 patients (12.17%) benefited of bipolar hemiarthroplasty prosthesis and 188 patients (81.74%) benefited of total hip arthroplasty. Osteonecrosis of the femoral head is characteristic to young patients between the age of 30-50 years old. Predisposing factors, alcohol and corticosteroid therapy remains an important cause of the disease. Total hip arthroplasty remains the best option for the patients with osteonecrosis of the femoral head.

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