Age- and Sex-Specific Risks of Major Cardiovascular Complications and All-Cause Mortality Following Elective Hip and Knee Arthroplasty in the Netherlands: A Dutch Hospital Data Registry Study
Mark J.R. Smeets MD , Maaike G.J. Gademan PhD , Rob G.H.H. Nelissen MD, PhD , Suzanne C. Cannegieter MD, PhD , Banne Nemeth MD, PhD
{"title":"Age- and Sex-Specific Risks of Major Cardiovascular Complications and All-Cause Mortality Following Elective Hip and Knee Arthroplasty in the Netherlands: A Dutch Hospital Data Registry Study","authors":"Mark J.R. Smeets MD , Maaike G.J. Gademan PhD , Rob G.H.H. Nelissen MD, PhD , Suzanne C. Cannegieter MD, PhD , Banne Nemeth MD, PhD","doi":"10.1016/j.artd.2024.101597","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Age and sex are well-known risk factors for cardiovascular complications and mortality following total hip arthroplasty (THA) and total knee arthroplasty (TKA). Yet, stratified up-to-date absolute risk estimates, which are needed to optimize prevention, are lacking.</div></div><div><h3>Methods</h3><div>All Dutch patients who had a first primary THA and TKA for osteoarthritis between 2015 and 2021 were included. Data on baseline characteristics, procedures, and outcomes were obtained from the Dutch Hospital Data and Population registries, after linkage. Overall risks for venous thromboembolism, arterial thromboembolism, bleeding, and all-cause mortality were estimated at 30 and 90 days following surgery. Time trends were assessed by plotting 90-day risks by year. Lastly, 90-day risks were stratified by age and sex categories.</div></div><div><h3>Results</h3><div>A total of 123,809 THA and 132,726 TKA patients were included. Females accounted for 63% and 65% of THA and TKA patients, respectively. At 90 days, overall risks were all below 1%. We observed no clear time trends in the risks over recent years. The stratified analysis showed that especially men older than 80 have a complication risk of at least 3%. Interestingly, the risk of venous thromboembolism and bleeding, following a THA, was observed to be relatively high in men and women in the youngest age category.</div></div><div><h3>Conclusions</h3><div>Generally, the 90-day incidence of cardiovascular complications and all-cause mortality is low but can be at least 3% for men in the highest age category. With this knowledge, perioperative preventive measures can be targeted more precisely, and shared decision-making improved.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101597"},"PeriodicalIF":1.5000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754685/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroplasty Today","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352344124002826","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Age and sex are well-known risk factors for cardiovascular complications and mortality following total hip arthroplasty (THA) and total knee arthroplasty (TKA). Yet, stratified up-to-date absolute risk estimates, which are needed to optimize prevention, are lacking.
Methods
All Dutch patients who had a first primary THA and TKA for osteoarthritis between 2015 and 2021 were included. Data on baseline characteristics, procedures, and outcomes were obtained from the Dutch Hospital Data and Population registries, after linkage. Overall risks for venous thromboembolism, arterial thromboembolism, bleeding, and all-cause mortality were estimated at 30 and 90 days following surgery. Time trends were assessed by plotting 90-day risks by year. Lastly, 90-day risks were stratified by age and sex categories.
Results
A total of 123,809 THA and 132,726 TKA patients were included. Females accounted for 63% and 65% of THA and TKA patients, respectively. At 90 days, overall risks were all below 1%. We observed no clear time trends in the risks over recent years. The stratified analysis showed that especially men older than 80 have a complication risk of at least 3%. Interestingly, the risk of venous thromboembolism and bleeding, following a THA, was observed to be relatively high in men and women in the youngest age category.
Conclusions
Generally, the 90-day incidence of cardiovascular complications and all-cause mortality is low but can be at least 3% for men in the highest age category. With this knowledge, perioperative preventive measures can be targeted more precisely, and shared decision-making improved.
期刊介绍:
Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.