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A National Analysis of Complications Following Total Hip Replacement in Patients With Chronic Obstructive Pulmonary Disease

View Article: PubMed Central - PubMed

ABSTRACT

Patients with chronic obstructive pulmonary disease (COPD) have a high risk of osteoporosis and fractures. The incidence rate of hip fracture has steadily increased over time and is a major common event in patients with osteoporosis and COPD. Total hip replacement (THR) is commonly performed in patients with hip fracture. Our aim was to compare the complications of THR between patients with and without COPD.

Longitudinally linked data from the National Health Insurance Research Database, which consists of registration, claims, and reimbursement records, for a cohort of 1,000,000 randomly selected enrollees traced retrospectively from 1996 to 2000 in Taiwan. Patients who had undergone THR surgery between January 1, 2004, and December 31, 2008, were identified and divided into COPD and non-COPD cohorts. Outcomes and complications, including 90-day mortality, 1-year mortality, 1-year wound infection, 30-day readmission for hospitalization, 30-day pneumonia, 30-day acute respiratory failure, 30-day cerebrovascular accident, and length of stay during hospitalization, were measured after THR.

The COPD group had a significantly higher ratio of complications, including 30-day readmission (14.0% vs 8.4%), 30-day pneumonia (10.4% vs 4.4%), 30-day acute respiratory failure (1.5% vs 0.5%), 1-year mortality (6.9% vs 2.7%), and length of stay in the hospital (10.6% vs 0.8%) than the non-COPD group.

In addition to airway diseases, patients in the COPD group had higher mortality than those in non-COPD group after THR. Surgeons should give more attention to airway evaluation and selection of patients with COPD for THR.

No MeSH data available.


Related in: MedlinePlus

Cumulative incidence rates of complications as shown by (A) 30-day readmissions, (B) development of pneumonia within 30 days, and (C) 1-year mortality in patients with and without chronic obstructive pulmonary disease (COPD) after receiving total hip replacement. Significant differences in the complication risks between the 2 groups are shown by the log-rank test. The cumulative incidence curves show that the patients with COPD had a higher incidence rate than those without COPD did.
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Figure 2: Cumulative incidence rates of complications as shown by (A) 30-day readmissions, (B) development of pneumonia within 30 days, and (C) 1-year mortality in patients with and without chronic obstructive pulmonary disease (COPD) after receiving total hip replacement. Significant differences in the complication risks between the 2 groups are shown by the log-rank test. The cumulative incidence curves show that the patients with COPD had a higher incidence rate than those without COPD did.

Mentions: Figure 2 shows the cumulative incidence curves of complications for the COPD and non-COPD groups. The log-rank test demonstrated significant differences in the complication risks between the COPD and non-COPD groups. The cumulative incidence curves of 30-day readmission, 30-day pneumonia, and 1-year mortality showed that the COPD group had significantly higher incidence rates than the non-COPD group did.


A National Analysis of Complications Following Total Hip Replacement in Patients With Chronic Obstructive Pulmonary Disease
Cumulative incidence rates of complications as shown by (A) 30-day readmissions, (B) development of pneumonia within 30 days, and (C) 1-year mortality in patients with and without chronic obstructive pulmonary disease (COPD) after receiving total hip replacement. Significant differences in the complication risks between the 2 groups are shown by the log-rank test. The cumulative incidence curves show that the patients with COPD had a higher incidence rate than those without COPD did.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998405&req=5

Figure 2: Cumulative incidence rates of complications as shown by (A) 30-day readmissions, (B) development of pneumonia within 30 days, and (C) 1-year mortality in patients with and without chronic obstructive pulmonary disease (COPD) after receiving total hip replacement. Significant differences in the complication risks between the 2 groups are shown by the log-rank test. The cumulative incidence curves show that the patients with COPD had a higher incidence rate than those without COPD did.
Mentions: Figure 2 shows the cumulative incidence curves of complications for the COPD and non-COPD groups. The log-rank test demonstrated significant differences in the complication risks between the COPD and non-COPD groups. The cumulative incidence curves of 30-day readmission, 30-day pneumonia, and 1-year mortality showed that the COPD group had significantly higher incidence rates than the non-COPD group did.

View Article: PubMed Central - PubMed

ABSTRACT

Patients with chronic obstructive pulmonary disease (COPD) have a high risk of osteoporosis and fractures. The incidence rate of hip fracture has steadily increased over time and is a major common event in patients with osteoporosis and COPD. Total hip replacement (THR) is commonly performed in patients with hip fracture. Our aim was to compare the complications of THR between patients with and without COPD.

Longitudinally linked data from the National Health Insurance Research Database, which consists of registration, claims, and reimbursement records, for a cohort of 1,000,000 randomly selected enrollees traced retrospectively from 1996 to 2000 in Taiwan. Patients who had undergone THR surgery between January 1, 2004, and December 31, 2008, were identified and divided into COPD and non-COPD cohorts. Outcomes and complications, including 90-day mortality, 1-year mortality, 1-year wound infection, 30-day readmission for hospitalization, 30-day pneumonia, 30-day acute respiratory failure, 30-day cerebrovascular accident, and length of stay during hospitalization, were measured after THR.

The COPD group had a significantly higher ratio of complications, including 30-day readmission (14.0% vs 8.4%), 30-day pneumonia (10.4% vs 4.4%), 30-day acute respiratory failure (1.5% vs 0.5%), 1-year mortality (6.9% vs 2.7%), and length of stay in the hospital (10.6% vs 0.8%) than the non-COPD group.

In addition to airway diseases, patients in the COPD group had higher mortality than those in non-COPD group after THR. Surgeons should give more attention to airway evaluation and selection of patients with COPD for THR.

No MeSH data available.


Related in: MedlinePlus