Abstract
This prospective study aimed to establish if octogenarians undergoing primary hip arthroplasty experienced a similar clinical outcome and complication rate as younger patients.
A total of 585 patients were recruited over a 4-year period. Patients aged 70–79 years and 80–89 years (octogenarians) were placed into separate groups.
Harris hip and SF-36 scores were obtained before and at 6 and 18 months following surgery. Other measurements included: blood loss; blood transfusion rate; wound infection; thromboembolism; dislocation and 90-day mortality.
Statistical analysis included a two-sample t-test and chi-squared analysis with Yates correction to compare results in each group. Analysis of covariance was used to calculate confidence limits for the effect of age group on Harris hip and SF-36 scores at 6 and 18 months after adjusting for levels recorded prior to surgery. Multiple logistic regression analysis was performed to determine any predictive factors for a noted difference in blood transfusion rates between patient cohorts.
A significantly better (P=0.019) improvement in mean Harris Hip score (SD) was seen 18-months after surgery in the younger cohort (43.4 (13.8) compared to 39.8 (10.6)). Length of hospital stay was longer (P< 0.001) in the octogenarians (12.9 (SD 7.0) days versus 10.1 (SD 4.7)) with a higher blood transfusion rate of 40% compared to 28% (P = 0.009). Lower pre-operative haemoglobin levels strongly correlated with the need for blood transfusion. No significant differences in infection, dislocation, thromboembolism or 90-day mortality rates were found.
Conclusions: Octogenarians are more likely to require blood transfusion and a longer hospital stay, with less improvement in clinical outcome at 18 months after primary hip arthroplasty.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
