Postoperative mortality after total hip arthroplasty. An analysis of deaths after two thousand seven hundred and thirty-six procedures.

摘要: We retrospectively determined the prevalence and nature of mortality as many ninety days after 2736 primary revision total hip arthroplasties performed in 2002 patients by one surgeon at a teaching hospital between January 1969 December 1996. All but seventy-one had received prophylaxis against venous thromboembolic disease. There were no intraoperative deaths, events during operation could be linked directly to postoperative mortality. Eight deaths (mortality rate, 0.3 per cent) occurred within procedures. Four 0.15 initial hospitalization. The cause seven was determined. Three died result preexisting disease (severe hepatorenal disease, metastatic esophageal cancer, or severe cardiac disease), patient from sepsis with gram-negative organism thoracotomy eight postoperatively. A bleeding complication that while receiving warfarin therapy led death two other patients; these 1974 other, 1982. At time managed, desired prothrombin considered twice control value. remaining patient, who clip placed on inferior vena cava pulmonary embolus 1970, secondary acute, thrombosis this vessel arthroplasty 1971. for whom not an artificial aortic valve been chronic therapy. She suddenly eighty-nine postoperatively; autopsy performed. No direct known embolus. related its treatment 1982 (1458 operations). attribute this, part, reduced levels improved management warfarin. ninety-day rate procedures over nearly three decades low (0.3 cent). This span included period before introduction current improvements perioperative care, such routine intubation under general anesthesia, continuous monitoring electrocardiogram intraoperatively, blood-gas determinations. When known, excluded, 0.18 cent (five 2733).