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Comorbidity does not predict long-term mortality after total hip arthroplasty

Bülow, Erik; Rolfson, Ola; Cnudde, Peter; Rogmark, Cecilia LU ; Garellick, Göran and Nemes, Szilárd (2017) In Acta Orthopaedica 88(5). p.472-477
Abstract

Background and purpose — In-hospital death following total hip arthroplasty (THA) is related to comorbidity. The long-term effect of comorbidity on all-cause mortality is, however, unknown for this group of patients and it was investigated in this study. Patients and methods — We used data from the Swedish Hip Arthroplasty Register, linked to the National Patient Register from the National Board of Health and Welfare, for patients operated on with THA in 1999–2012. We identified 120,836 THAs that could be included in the study. We evaluated the predictive power of the Charlson and Elixhauser comorbidity indices on mortality, using concordance indices calculated after 5, 8, and 14 years after THA. Results — All comorbidity indices... (More)

Background and purpose — In-hospital death following total hip arthroplasty (THA) is related to comorbidity. The long-term effect of comorbidity on all-cause mortality is, however, unknown for this group of patients and it was investigated in this study. Patients and methods — We used data from the Swedish Hip Arthroplasty Register, linked to the National Patient Register from the National Board of Health and Welfare, for patients operated on with THA in 1999–2012. We identified 120,836 THAs that could be included in the study. We evaluated the predictive power of the Charlson and Elixhauser comorbidity indices on mortality, using concordance indices calculated after 5, 8, and 14 years after THA. Results — All comorbidity indices performed poorly as predictors, in fact worse than a base model with age and sex only. Elixhauser was, however, the least bad choice and it predicted mortality with concordance indices 0.59, 0.58, and 0.56 for 5, 8, and 14 years after THA. Interpretation — Comorbidity indices are poor predictors of long-term mortality after THA.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
88
issue
5
pages
472 - 477
publisher
Taylor & Francis
external identifiers
  • scopus:85021424332
  • wos:000407612900003
ISSN
1745-3674
DOI
10.1080/17453674.2017.1341243
language
English
LU publication?
yes
id
184730c9-19ca-42ba-b261-27a54bd18b1e
date added to LUP
2017-08-11 15:12:36
date last changed
2018-01-07 12:14:34
@article{184730c9-19ca-42ba-b261-27a54bd18b1e,
  abstract     = {<p>Background and purpose — In-hospital death following total hip arthroplasty (THA) is related to comorbidity. The long-term effect of comorbidity on all-cause mortality is, however, unknown for this group of patients and it was investigated in this study. Patients and methods — We used data from the Swedish Hip Arthroplasty Register, linked to the National Patient Register from the National Board of Health and Welfare, for patients operated on with THA in 1999–2012. We identified 120,836 THAs that could be included in the study. We evaluated the predictive power of the Charlson and Elixhauser comorbidity indices on mortality, using concordance indices calculated after 5, 8, and 14 years after THA. Results — All comorbidity indices performed poorly as predictors, in fact worse than a base model with age and sex only. Elixhauser was, however, the least bad choice and it predicted mortality with concordance indices 0.59, 0.58, and 0.56 for 5, 8, and 14 years after THA. Interpretation — Comorbidity indices are poor predictors of long-term mortality after THA.</p>},
  author       = {Bülow, Erik and Rolfson, Ola and Cnudde, Peter and Rogmark, Cecilia and Garellick, Göran and Nemes, Szilárd},
  issn         = {1745-3674},
  language     = {eng},
  month        = {06},
  number       = {5},
  pages        = {472--477},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica},
  title        = {Comorbidity does not predict long-term mortality after total hip arthroplasty},
  url          = {http://dx.doi.org/10.1080/17453674.2017.1341243},
  volume       = {88},
  year         = {2017},
}