Risk of further surgery on the same or opposite side and mortality after primary total hip arthroplasty: A multi-state analysis of 133,654 patients from the Swedish Hip Arthroplasty Register.

2.50
Hdl Handle:
http://hdl.handle.net/11287/620731
Title:
Risk of further surgery on the same or opposite side and mortality after primary total hip arthroplasty: A multi-state analysis of 133,654 patients from the Swedish Hip Arthroplasty Register.
Authors:
Cnudde, P. H. J.; Nemes, S.; Bülow, E.; Timperley, John; Whitehouse, S. L.; Kärrholm, J.; Rolfson, O.
Abstract:
Background and purpose - The hip-related timeline of patients following a total hip arthroplasty (THA) can vary. Ideally patients will live their life without need for further surgery; however, some will undergo replacement on the contralateral hip and/or reoperations. We analyzed the probability of mortality and further hip-related surgery on the same or contralateral hip. Patients and methods - We performed a multi-state survival analysis on a prospectively followed cohort of 133,654 Swedish patients undergoing an elective THA between 1999 and 2012. The study used longitudinally collected information from the Swedish Hip Arthroplasty Register and administrative databases. The analysis considered the patients' sex, age, prosthesis type, surgical approach, diagnosis, comorbidities, education, and civil status. Results - During the study period patients were twice as likely to have their contralateral hip replaced than to die. However, with passing time, probabilities converged and for a patient who only had 1 non-revised THA at 10 years, there was an equal chance of receiving a second THA and dying (24%). It was 8 times more likely that the second hip would become operated with a primary THA than that the first hip would be revised. Multivariable regression analysis reinforced the influence of age at operation, sex, diagnosis, comorbidity, and socioeconomic status influencing state transition. Interpretation - Multi-state analysis can provide a comprehensive model of further states and transition probabilities after an elective THA. Information regarding the lifetime risk for bilateral surgery, revision, and death can be of value when discussing the future possible outcomes with patients, in healthcare planning, and for the healthcare economy.
Citation:
Risk of further surgery on the same or opposite side and mortality after primary total hip arthroplasty: A multi-state analysis of 133,654 patients from the Swedish Hip Arthroplasty Register. 2018:1-8 Acta Orthop
Publisher:
Taylor & Francis
Journal:
Acta orthopaedica
Issue Date:
23-May-2018
URI:
http://hdl.handle.net/11287/620731
DOI:
10.1080/17453674.2018.1475179
PubMed ID:
29792086
Additional Links:
http://www.tandfonline.com/doi/full/10.1080/17453674.2018.1475179
Type:
Journal Article
Language:
en
ISSN:
1745-3682
Appears in Collections:
Exeter Hip Unit; 2018 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorCnudde, P. H. J.en
dc.contributor.authorNemes, S.en
dc.contributor.authorBülow, E.en
dc.contributor.authorTimperley, Johnen
dc.contributor.authorWhitehouse, S. L.en
dc.contributor.authorKärrholm, J.en
dc.contributor.authorRolfson, O.en
dc.date.accessioned2018-06-29T14:04:01Z-
dc.date.available2018-06-29T14:04:01Z-
dc.date.issued2018-05-23-
dc.identifier.citationRisk of further surgery on the same or opposite side and mortality after primary total hip arthroplasty: A multi-state analysis of 133,654 patients from the Swedish Hip Arthroplasty Register. 2018:1-8 Acta Orthopen
dc.identifier.issn1745-3682-
dc.identifier.pmid29792086-
dc.identifier.doi10.1080/17453674.2018.1475179-
dc.identifier.urihttp://hdl.handle.net/11287/620731-
dc.description.abstractBackground and purpose - The hip-related timeline of patients following a total hip arthroplasty (THA) can vary. Ideally patients will live their life without need for further surgery; however, some will undergo replacement on the contralateral hip and/or reoperations. We analyzed the probability of mortality and further hip-related surgery on the same or contralateral hip. Patients and methods - We performed a multi-state survival analysis on a prospectively followed cohort of 133,654 Swedish patients undergoing an elective THA between 1999 and 2012. The study used longitudinally collected information from the Swedish Hip Arthroplasty Register and administrative databases. The analysis considered the patients' sex, age, prosthesis type, surgical approach, diagnosis, comorbidities, education, and civil status. Results - During the study period patients were twice as likely to have their contralateral hip replaced than to die. However, with passing time, probabilities converged and for a patient who only had 1 non-revised THA at 10 years, there was an equal chance of receiving a second THA and dying (24%). It was 8 times more likely that the second hip would become operated with a primary THA than that the first hip would be revised. Multivariable regression analysis reinforced the influence of age at operation, sex, diagnosis, comorbidity, and socioeconomic status influencing state transition. Interpretation - Multi-state analysis can provide a comprehensive model of further states and transition probabilities after an elective THA. Information regarding the lifetime risk for bilateral surgery, revision, and death can be of value when discussing the future possible outcomes with patients, in healthcare planning, and for the healthcare economy.en
dc.language.isoenen
dc.publisherTaylor & Francisen
dc.relation.urlhttp://www.tandfonline.com/doi/full/10.1080/17453674.2018.1475179en
dc.rightsArchived with thanks to Acta orthopaedicaen
dc.subjectWessex Classification Subject Headings::Orthopaedicsen
dc.titleRisk of further surgery on the same or opposite side and mortality after primary total hip arthroplasty: A multi-state analysis of 133,654 patients from the Swedish Hip Arthroplasty Register.en
dc.typeJournal Articleen
dc.identifier.journalActa orthopaedicaen
dc.type.versionIn press (epub ahead of print)en

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