SSc linked to higher rates of complications, healthcare use after THA

Systemic sclerosis (SSc) contributes to higher in-hospital complications and healthcare use following primary total hip arthroplasty (THA), reveal the results a recent study.

The investigators analysed 4,116,485 primary THA performed in the US using the 1998–2014 National Inpatient Sample. They identified THA and SSc using procedure and diagnostic codes, respectively.

Multivariable-adjusted logistic regression analyses were performed to assess the relationship of SSc with in-hospital complications (eg, implant infection, revision, transfusion, mortality) post-THA and associated healthcare use (eg, hospital charges, hospital stay, discharge to nonhome setting), adjusting for age, sex, race, Deyo-Charlson comorbidity index, primary diagnosis for THA, household income, and insurance payer status.

Of the total THA performed from 1998 to 2014, 0.06 percent (n=2,672) were done on SSc patients. Multivariable-adjusted analyses showed that people with vs without SSc were at greater risk of the following post-THA: nonhome discharge (odds ratio [OR], 1.25, 95 percent confidence interval [CI], 1.03–1.50), hospital stay >3 days (OR, 1.61, 95 percent CI, 1.35–1.92), transfusion (OR, 1.54, 95 percent CI, 1.28–1.84), and in-hospital revision (OR, 9.53, 95 percent CI, 6.75–13.46).

In addition, a nonsignificant trend was observed concerning differences in in-hospital mortality (OR, 2.19, 95 percent CI, 0.99–4.86). No differences were seen in total hospital charges or implant infection rates.

“Future studies should examine whether pre- or postoperative interventions can reduce the risk of post-THA complications in people with SSc,” the investigators said.