Association of Partial Hip Replacement With Higher Risk of Infection and Mortality in France

2016 ◽  
Vol 38 (1) ◽  
pp. 123-125 ◽  
Author(s):  
Leslie Grammatico-Guillon ◽  
Caroline Perreau ◽  
Katiuska Miliani ◽  
Francois L’Heriteau ◽  
Philippe Rosset ◽  
...  
Keyword(s):  
Hip Replacement ◽  
Risk Of Infection ◽  
Partial Hip Replacement

scholarly journals Outcome in the Patients with Idiopathic Osteonecrosis of the Femoral Head after Total or Partial Hip Replacement

2011 ◽  
Vol 60 (2) ◽  
pp. 322-324
Author(s):  
Akira Hashimoto ◽  
Shunsuke Kawano ◽  
Masaru Kitajima ◽  
Motoki Sonohata ◽  
Masaaki Mawatari ◽  
...  
Keyword(s):  
Femoral Head ◽  
Hip Replacement ◽  
Partial Hip Replacement

Rates of Surgical Site Infection After Hip Replacement as a Hospital Performance Indicator: Analysis of Data From the English Mandatory Surveillance System

2008 ◽  
Vol 29 (3) ◽  
pp. 219-226 ◽  
Author(s):  
J. Wilson ◽  
A. Charlett ◽  
G. Leong ◽  
C. McDougall ◽  
G. Duckworth
Keyword(s):  
Confidence Interval ◽  
Surgical Site Infection ◽  
Hip Replacement ◽  
Performance Indicator ◽  
Hospital Performance ◽  
Incidence Rates ◽  
Site Infection ◽  
Risk Of Infection ◽  
Data Set ◽  
Funnel Plots

Objective.To describe rates of surgical site infection (SSI) after hip replacement and to use these data to provide a simple mechanism for identifying poorly performing hospitals that takes into account variations in sample size.Design.Prospective surveillance study.Setting.A total of 125 acute care hospitals in England that participated in mandatory SSI surveillance from April 1, 2004 through March 31, 2005.Patients.Patients who underwent total hip replacement (THR) or hip hemiarthroplasty (HH).Methods.A standard data set was collected for all eligible operations at participating hospitals for a minimum of 3 months annually. Defined methods were used to identify SSIs that occurred during the inpatient stay. Data were checked for quality and accuracy, and funnel plots were constructed by plotting the incidence of SSI against the number of operations.Results.Data were collected on 16,765 THRs and 5,395 HHs. The cumulative SSI incidence rates were 1.26% for THR and 4.06% for HH; the incidence densities were 1.38 SSIs per 1,000 postoperative inpatient days for THR and 2.3 SSIs per 1,000 postoperative inpatient days for HH. The risk of infection associated with revision surgery was significantly higher than that associated with primary surgery (2.7% [95% confidence interval, 2.0%-3.5%] vs. 1.1% [95% confidence interval, 1.0%-1.2%];P = .003). Rates varied considerably among hospitals. Nineteen hospitals had rates above the 90th percentile. However, the use of funnel plots to adjust for the precision of estimated SSI rates identified 7 hospitals that warranted further investigation, including 2 with crude rates below the 90th percentile.Conclusions.Funnel plots of rates of SSI after hip replacement provide a valuable method of presenting hospital performance data, clearly identifying hospitals with unusually high or low rates while adjusting for the precision of the estimated rate. This information can be used to target and support local interventions to reduce the risk of infection.

Anaesthetic choice for hip or knee arthroplasty in New Zealand: Risk of postoperative death and variations in use

2021 ◽  
pp. 0310057X2110509
Author(s):  
Jason K Gurney ◽  
Melissa A McLeod ◽  
Douglas Campbell ◽  
Elizabeth Dennett ◽  
Sarah Jackson ◽  
...  
Keyword(s):  
New Zealand ◽  
Hip Replacement ◽  
Regional Anaesthesia ◽  
Postoperative Mortality ◽  
National Study ◽  
Increased Risk ◽  
Large Joint ◽  
The Impact ◽  
Partial Hip Replacement ◽  
Over Time

Anaesthetic choice for large joint surgery can impact postoperative outcomes, including mortality. The extent to which the impact of anaesthetic choice on postoperative mortality varies within patient populations and the extent to which anaesthetic choice is changing over time remain under-explored both internationally and in the diverse New Zealand context. In a national study of 199,211 hip and knee replacement procedures conducted between 2005 and 2017, we compared postoperative mortality among those receiving general, regional or general plus regional anaesthesia. Focusing on unilateral ( n=86,467) and partial ( n=13,889) hip replacements, we assessed whether some groups within the population are more likely to receive general, regional or general plus regional anaesthesia than others, and whether mortality risk varies depending on anaesthetic choice. We also examined temporal changes in anaesthetic choice over time. Those receiving regional alone or general plus regional for unilateral hip replacement appeared at increased risk of 30-day mortality compared to general anaesthesia alone, even after adjusting for differences in terms of age, ethnicity, deprivation, rurality, comorbidity, American Society of Anesthesiologists physical status score and admission type (e.g. general plus regional: adjusted hazard ratio (adj. HR)=1.94, 95% confidence intervals (CI) 1.32 to 2.84). By contrast, we observed lower 30-day mortality among those receiving regional anaesthesia alone compared to general alone for partial hip replacement (adj. HR=0.86, 95% CI 0.75 to 0.97). The latter observation contrasts with declining temporal trends in the use of regional anaesthesia alone for partial hip replacement procedures. However, we recognise that postoperative mortality is one perioperative factor that drives anaesthetic choice.

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