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RISK-PROFILING IN TOTAL HIP REPLACEMENT BASED ON PERIOPERATIVE COMPLICATIONS OF 29994 TOTAL HIP REPLACEMENTS

7th Congress of the European Federation of National Associations of Orthopaedics and Traumatology, Lisbon - 4-7 June, 2005



Abstract

Introduction: Risk-profiling of patients in hip arthroplasty to prepare for perioperative complications is becoming more important. Materials and Methods Major complications (haematoma, cardiovascular complication, deep venous thrombosis, pulmonary embolism, joint infection, injuries of neurovascular structures and pneumonia) following 29994 hip arthroplasties occurring within the postoperative hospitalisation period have been documented based on a standardised protocol used for external quality assessment in Germany. Using logistic regression, the influence of potential risk factors was assessed for their significance on postoperative complications and univariate analysis was used to assess this influence on every single major complication. The influence of patient age and the surgery time on major complications were calculated using ANOVA.

Results: Major perioperative complications occurred in 7,26 per cent. Haematomas were reported in 3.22, cardiovascular complications in 1.55, joint infections in 0.94, injuries of neuro-vascular structures in 0,63, deep venous thrombosis in 0.37, pulmonary embolism in 0.26 and pneumonia in 0.28 per cent of all cases. Patient age, length of surgery and allogeneic blood transfusion significantly increased the rate of major perioperative complications. Increased patient age increased the risk for all major complications but neuro-vascular injuries. Increased surgery time elevated the risk for all major complications except haematoma. Allogeneic blood transfusions were associated with an elevated risk for all major postoperative complications except deep venous thrombosis. In contrast, autologous blood transfusions did not increase the risk for suffering a postoperative complication. Surprisingly, gender did not have a significant influence on the occurrence of immediate postoperative complications. Conclusions Allogeneic blood transfusion, increased age and surgery time contribute to an elevated incidence of perioperative complications following hip arthroplasty.

Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.