What Is the Impact of Advancing Age on the Outcomes of Total Hip Arthroplasty?

作者：Murphy Benjamin P d'S^*; Dowsey Michelle M; Spelman Tim; Choong Peter F M

来源：Journal of Arthroplasty, 2018, 33(4): 1101-+.

DOI：10.1016/j.arth.2017.11.010

• hip arthroplasty
• knee arthroplasty
• octogenarian
• complications
• mortality
• physical functioning

Background: The global demand for total hip arthroplasty (THA) is increasing, underscoring its moniker as the "operation of the century." However, debate still exists as to whether the elderly who undergo the operation achieve the same outcomes as those younger. In this study, we sought to investigate the association between older age and the risks and benefits of THA.
Methods: In this study, we aimed to compare the risks and benefits of THA of those aged >= 80 years vs those <80 years. We analyzed the physical status component of the Short-Form 12 Health Survey, complications within 12 months, all-cause mortality, length of hospital stay (LOS), and discharge to rehabilitation in 2457 cases of primary THA using multivariate modeling.
Results: There was no difference in improvement of those older vs the younger group in physical functioning. However, the older group had 2.87 times greater odds of experiencing a post-operative medical complication and 3.49 times the rate of all-cause mortality (P < .001). Additionally, the older group encountered an additional median 0.21-day increase in LOS and had 3.93 times greater odds of being discharged to rehabilitation rather than home (P < .001). We were unable to demonstrate any difference between groups in terms of post-operative surgical or wound-related complications.
Conclusion: The elderly stand to gain equivalent benefits from THA as those younger in terms of physical functioning. However, this benefit needs to be balanced against the increased risk of post-operative medical complications, increased LOS, increased requirement for rehabilitation, and ultimately the increased risk of mortality.

• 出版日期2018-4