Perioperative Risk of Hip Arthroplasty in Patients with Cirrhotic Liver Disease.
10.3346/jkms.2007.22.2.223
- Author:
Young Wan MOON
1
;
Yong Sik KIM
;
Soon Yong KWON
;
Shin Yoon KIM
;
Seung Jae LIM
;
Youn Soo PARK
Author Information
1. Department of Orthopedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, 50 Ilwon-dong, Gangnam-gu, Seoul, Korea. yspark@smc.samsung.co.kr
- Publication Type:Original Article
- Keywords:
Hip Arthroplasty;
Liver Cirrhosis;
Perioperative Complications;
Risk Factors
- MeSH:
Surgical Wound Infection/diagnosis/*etiology;
Risk Factors;
Risk Assessment/*methods;
Prosthesis-Related Infections/diagnosis/*etiology;
Middle Aged;
Male;
Liver Cirrhosis/*complications;
Humans;
Gastrointestinal Hemorrhage/diagnosis/*etiology;
Female;
Arthroplasty, Replacement, Hip/*adverse effects;
Adult;
Adolescent
- From:Journal of Korean Medical Science
2007;22(2):223-226
- CountryRepublic of Korea
- Language:English
-
Abstract:
We retrospectively reviewed the complete medical records of 30 patients with a diagnosis of liver cirrhosis who had undergone hip arthroplasty at three academic institutions between October 1994 and May 2001. There were 26 males and 4 females with a mean age of 60 yr at index operation. Surgical procedures included 17 primary total hip arthroplasties (THA), 8 bipolar hemiarthroplasties, and 5 revision THAs. According to the Child-Pugh scoring system, 19 cirrhotic patients were categorized as class A, 9 as class B, and 2 as class C. Eight (26.7%) of the 30 patients had one or more perioperative complications. Of these, wound infection was the most common, with a rate of 10% (3 of 30 hips). Other perioperative complications included surgical site bleeding, coagulopathy, encephalopathy, gastrointestinal bleeding, pneumonia, and arrhythmia. Death occurred in 2 (6.7%) of the 30 patients; both were Child-Pugh's C cirrhotics. A higher Child-Pugh score (p=0.0001) and a high level of creatinine (p=0.0499) were associated with significantly increased perioperative complications or death. Our findings suggest that surgeons should be vigilant about perioperative complications in patients with advanced cirrhotic liver disease who undergo hip arthroplasty, albeit the mortality rates are relatively low in less severe cirrhotics.
