MORTALITY AND FATAL PULMONARY EMBOLISM AFTER PRIMARY TOTAL HIP REPLACEMENTRESULTS FROM A REGIONAL HIP REGISTERD. Fender, FRCS, Orthopaedic Research Fellow1; W. M. Harper, MD, FRCS Ed, Senior Lecturer and Honorary Consultant Orthopaedic Surgeon1; J. R. Thompson, PhD, Senior Lecturer in Epidemiology and Public Health Medicine2; and P. J. Gregg, MD, FRCS, Professor of Orthopaedic Surgery3
1 University of Leicester, Clinical Sciences Building, Glenfield General NHS Trust, Groby Road, Leicester LE3 9QP, UK. Correspondence should be sent to Mr D. Fender at the Department of Orthopaedic Surgery, The Medical School, Framlington Place, Newcastle upon Tyne NE1 7RU, UK. We calculated the rates for perioperative mortality and fatal pulmonary embolism (PE) after primary total hip replacement in a single UK health region, using a regional arthroplasty register and the tracing service of the Office of National Statistics. During 1990, there were 2111 consecutive primary replacements in 2090 separate procedures. Within 42 days of operation a total of 19 patients had died (0.91%, 95% CI 0.55 to 1.42). Postmortem examination showed that four deaths (0.19%, 95% CI 0.05 to 0.49) were definitely due to PE. The overall perioperative mortality and fatal PE rates are low and in our study did not appear to be altered by the use of chemical thromboprophylaxis (perioperative mortality rate: one-tailed Fisher’s exact test, p = 0.39; fatal PE rate: one-tailed Fisher’s exact test, p = 0.56). The routine use of chemical thromboprophylaxis for primary THR is still controversial. The issue should be addressed by an appropriate randomised, prospective study using overall mortality and fatal PE rate as the main outcome measures, but the feasibility of such a study is questioned. This article has been cited by other articles:
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