Predictors Of Early Mortality Following Total Hip Arthroplasty In Hemodialysis Patients

Purpose. To identify risk factors associated with early death in hemodialysis (HD) patients undergoing total hip arthroplasty (THA).Materials and Methods. We retrospectively reviewed 27 HD patients who underwent THA between 1994 and 2000. Their average age was 63 yr, and the average duration of HD was 120 mo at the time of operation. The body mass index (BMI), operating time, and total blood loss were determined. Serum levels of albumin (Alb), calcium (Ca), phosphorus (P), alkaline phosphatase (Alp), and intact parathyroid hormone (PTH) were measured preoperatively.Results. Among these 2 7 patients, 6 (22%) died: 2 perioperatively and 4 during the 19-mo follow-up. There were no significant differences between survivors and those who died with respect to age, duration of HD, Alb, Ca, P, Alp, operating time, or total blood loss. However, patients with lower BMI and PTH levels had a significantly higher mortality rate than did patients with higher BMI and PTH levels (p < 0.05 and p < 0.01, respectively).Conclusion. We conclude that despite intensive care for HD patients, the incidence of early death following THA is still high. If the BMI and serum PTH are low preoperatively, attention should be paid to the risk of early mortality following the procedure.