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Clinical Outcomes in Patients with Pulmonary Hypertension Undergoing Total Hip Arthroplasty

  • Original Article
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HSS Journal ®

Abstract

Background

Pulmonary hypertension (PH) is regarded as a risk factor for perioperative complications in patients undergoing noncardiac surgery.

Questions/Purposes

The objective of this retrospective case–control study was to evaluate the adverse outcomes of pulmonary hypertension patients undergoing elective unilateral hip replacements.

Methods

We performed a retrospective case–control study of total hip replacement patients with pulmonary hypertension (cases) and without pulmonary hypertension (control). From the years 2003 to 2008, we identified a total of 132 patients undergoing primary total hip replacements with a diagnosis of pulmonary hypertension (right ventricular systolic pressure >35). The primary outcome assessed was the incidence of adverse events that occurred during the postoperative hospital stay. Secondary outcomes studied included length of hospital stay, mortality, and ability to reach certain physical therapy milestones.

Results

The PH group had significantly more adverse events than the control group. Nonlethal cardiac dysrhythmias comprised the most common adverse outcome among the PH group. Overall, the PH group had a morbidity rate of 34.7% while the control had a rate of 21%. The PH group had longer hospital stay (6.7 days vs. 5.9). Both groups had zero mortality during the hospital stay. The PH group had comparable rehabilitation recovery times than the control group.

Conclusion

This retrospective case–control study demonstrates that pulmonary hypertension patients undergoing total hip arthroplasty are more prone to adverse outcomes, especially cardiac dysrhythmias, and longer hospital stays.

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Acknowledgments

Dr. Yan Ma’s contribution on this project was supported in part by the National Institute of Health (NIH), grant no. UL1-RR024996 and Agency for Healthcare and Quality Research (AHRQ, Rockville, MD) grant no. R01HS021734. We would like to thank Daniel Yoo for assisting in the final editing and reorganization of the manuscript.

Disclosures

ᅟ

Conflict of Interest:

David Kim, MD, Kethy Jules-Elysee, MD, Shane Reid, BA, Michael K. Urban, MD, PhD, Lauren Turteltaub, MD, Jacques T. YaDeau, MD, PhD, and Stephen Lyman, PhD have declared that they have no conflict of interest. Yan Ma, PhD reports grants from NIH and AHRQ during the conduct of the study.

Human/Animal Rights:

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed Consent:

Informed consent was obtained from all patients for being included in the study.

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Disclosure forms provided by the authors are available with the online version of this article.

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Authors and Affiliations

  1. Department of Anesthesiology, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    David Kim MD, Kethy Jules-Elysee MD, Lauren Turteltaub MD, Michael K. Urban MD, PhD, Jacques T. YaDeau MD, PhD, Shane Reid BA & Stephen Lyman PhD

  2. Division of Biostatics and Epidemiology, Department of Public Health, Weill Cornell Medical College, New York, NY, 10065, USA

    Stephen Lyman PhD & Yan Ma PhD

Authors
  1. David Kim MD
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  2. Kethy Jules-Elysee MD
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  3. Lauren Turteltaub MD
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  4. Michael K. Urban MD, PhD
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  5. Jacques T. YaDeau MD, PhD
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  6. Shane Reid BA
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  7. Stephen Lyman PhD
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  8. Yan Ma PhD
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Corresponding author

Correspondence to David Kim MD.

Additional information

Level of Evidence: Level III: Prognostic Study.

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Kim, D., Jules-Elysee, K., Turteltaub, L. et al. Clinical Outcomes in Patients with Pulmonary Hypertension Undergoing Total Hip Arthroplasty. HSS Jrnl 10, 131–135 (2014). https://doi.org/10.1007/s11420-014-9391-y

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  • DOI: https://doi.org/10.1007/s11420-014-9391-y

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