Ninety-day Mortality in Patients Undergoing Elective Total Hip or Total Knee Arthroplasty

Using an institutional joint registry, we studied frequency, trends and predictors of mortality after elective total hip or knee arthroplasty (THA/TKA). Of the 12 727 and 12 484 patients who underwent THA and TKA, respectively, all-cause mortality rates at 7-, 30-, and 90-days were as follows: THA, 0.1%, 0.2%, and 0.5%; TKA 0.1%. 0.2%, and 0.4%, respectively. Statistically significant downward time trend in 90-day mortality was noted after TKA (P = .02) but not after THA (P = .41). In multivariable-adjusted analyses of patients undergoing THA, older age, higher comorbidity index, and prior cardiac disease were significantly associated with higher 90-day mortality. In patients undergoing TKA, older age, male gender, a Society of Anesthesiologist class of III-IV, and higher comorbidity index were associated with higher 90-day all-cause mortality. Optimization of disease management may reduce postoperative mortality after THA/TKA.