School of Medicine and Health Sciences Poster Presentations

Title

The Influence of Gender on 30-Day Complications After Revision Total Hip Arthroplasty

Poster Number

261

Document Type

Poster

Status

Medical Student

Abstract Category

Health Sciences

Keywords

Arthroplasty, Gender, Complication, Revision

Publication Date

Spring 2018

Abstract

Introduction: Gender has been shown to affect clinical outcomes in several surgical sub-specialties. Analysis of the impact of gender on primary total joint arthroplasty has shown gender to be an independent risk factor for certain complications. To the authors knowledge, the relationship between gender and post-operative complications following revision total hip arthroplasty (THA) has not been studied previously. We hypothesized that gender differences would be a variable associated with post-operative complications following revision THA. Methods: The National Surgery Quality Improvement Database (NSQIP) was queried for revision THA procedures between 2005 and 2014. The NSQIP database follows patients during their in-hospital stay as well as 30 days post-operatively. Univariate and multivariate analyses were performed to determine whether gender was an independent risk factor for several post-operative complications. Results: Univariate analysis demonstrated that men were more likely to experience acute renal failure (p=.007) and cardiac arrest requiring resuscitation (p=.004). Univariate analysis revealed that women were more likely to experience blood transfusion (p<.001), urinary tract infection (UTI) (p<.001), non-home discharge (p<.001), and longer hospital length of stay when compared to men (p=.01). Multivariate analyses demonstrated similar results; women had a higher likelihood of developing a UTI (OR 2.19, P<.001), receiving a blood transfusion (OR 1.22, p<.001), and being discharged to rehab or skilled nursing facility (OR 1.56, p<.001). However, female gender was determined to be an independent protective factor for cardiac arrest requiring resuscitation (OR .219, p=.005). Conclusion: Gender is an independent risk factor for 30-day complications following revision THA, which are similar to the gender related complications previously identified in the setting of primary THA. These findings present an opportunity to appropriately counsel patients undergoing revision THA regarding their specific risk profile for a post-operative complication. In addition, further analysis is needed to evaluate the reasons behind the gender differences and to define peri-operative protocols to reduce risk where possible.

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The Influence of Gender on 30-Day Complications After Revision Total Hip Arthroplasty

Introduction: Gender has been shown to affect clinical outcomes in several surgical sub-specialties. Analysis of the impact of gender on primary total joint arthroplasty has shown gender to be an independent risk factor for certain complications. To the authors knowledge, the relationship between gender and post-operative complications following revision total hip arthroplasty (THA) has not been studied previously. We hypothesized that gender differences would be a variable associated with post-operative complications following revision THA. Methods: The National Surgery Quality Improvement Database (NSQIP) was queried for revision THA procedures between 2005 and 2014. The NSQIP database follows patients during their in-hospital stay as well as 30 days post-operatively. Univariate and multivariate analyses were performed to determine whether gender was an independent risk factor for several post-operative complications. Results: Univariate analysis demonstrated that men were more likely to experience acute renal failure (p=.007) and cardiac arrest requiring resuscitation (p=.004). Univariate analysis revealed that women were more likely to experience blood transfusion (p<.001), urinary tract infection (UTI) (p<.001), non-home discharge (p<.001), and longer hospital length of stay when compared to men (p=.01). Multivariate analyses demonstrated similar results; women had a higher likelihood of developing a UTI (OR 2.19, P<.001), receiving a blood transfusion (OR 1.22, p<.001), and being discharged to rehab or skilled nursing facility (OR 1.56, p<.001). However, female gender was determined to be an independent protective factor for cardiac arrest requiring resuscitation (OR .219, p=.005). Conclusion: Gender is an independent risk factor for 30-day complications following revision THA, which are similar to the gender related complications previously identified in the setting of primary THA. These findings present an opportunity to appropriately counsel patients undergoing revision THA regarding their specific risk profile for a post-operative complication. In addition, further analysis is needed to evaluate the reasons behind the gender differences and to define peri-operative protocols to reduce risk where possible.