A new study in the Journal of Bone and Joint Surgery (JBJS) has determined that elective orthopedic surgery is generally safe for patients ages 80 years and older with decreasing mortality and complication rates. The results of the study show decreasing mortality rates for total hip (THR) and total knee replacement (TKR) and spinal fusion surgeries, as well as decreasing complication rates for TKR and spinal fusion in patients with few or no comorbidities. For the study, researchers analyzed data for patients 80 years and older and ages 65 to 79 years from the Nationwide Inpatient Sample (NIS).
Factors including whether or not patients were discharged to their home or to a rehabilitation facility, mortality, and duration of hospital stay were retrieved and analyzed. The findings of the study show that the overall in-hospital complication rate remained stable, declining slightly from 2000 to 2009 in the 80 and older group, and the overall in-hospital complication rate notably decreased in patients without a comorbidity for spinal fusion and TKR.
Also, the in-hospital mortality rate in the 80 and older group averaged .9% for spinal fusion, .3% for TKR, and .5% for THR. The overall in-hospital complication and mortality rates were significantly higher for patients ages 80 years and older compared to patients age 65 to 79 years.
Hiroyuki Yoshihara, MD, PhD, lead author of the study, says, “Based on the results of this study, I think very elderly patients, particularly those with few or no comorbidities, should strongly consider the benefits of these procedures.”
Yoshihara adds, “Despite stable or increased in-hospital complications, the in-hospital mortality rate decreased over time for all three procedures. As life expectancy continues to increase, I hope that very elderly patients who have had inadequate results from exhaustive conservative treatment (for various orthopaedic conditions) undergo the procedures and have better life quality.”
Source: Science Daily