Mortality after hip Replacement

摘要

Linda Hunt and colleagues (Sept 28, p 1097) assessed 90-day mortality after total hip arthroplasty for osteoarthritis. There is no strong evidence indicating that mortality and morbidity after hip replacement remain higher than in the general population 90 days after surgery. A recent study suggested that the risk of myocardial infarction after hip replacement is high during the first 2 weeks after surgery and decreases after 6 weeks.Hunt and colleagues' study indicated that the use of chemical prophylaxis, posterior approach, and spinal anaesthesia reduce the mortality rate. Chemical prophylaxis includes a large variety of drugs-including warfarin and aspirin. The authors' claim of a protective effect of chemical prophylaxis on mortality should be interpreted with caution; it is not a green light for aggressive postoperative prophylaxis for low-risk patients at the expense of increased risk of postoperative complications, particularly surgical-site infection.