Featured Research

from universities, journals, and other organizations

Orthopedic surgery generally safe for patients age 80 and older

Date:
July 17, 2014
Source:
American Academy of Orthopaedic Surgeons
Summary:
Over the past decade, a greater number of patients, age 80 and older, are having elective orthopedic surgery. A new study has found that these surgeries are generally safe with mortality rates decreasing for total hip (THR) and total knee (TKR) replacement and spinal fusion surgeries, and complication rates decreasing for total knee replacement and spinal fusion in patients with few or no comorbidities (other conditions or diseases).

Over the past decade, a greater number of patients, age 80 and older, are having elective orthopaedic surgery. A new study appearing in the Journal of Bone and Joint Surgery(JBJS) found that these surgeries are generally safe with mortality rates decreasing for total hip (THR) and total knee (TKR) replacement and spinal fusion surgeries, and complication rates decreasing for total knee replacement and spinal fusion in patients with few or no comorbidities (other conditions or diseases).

"Based on the results of this study, I think very elderly patients, particularly those with few or no comorbidities, should strongly consider the benefits of these procedures," said lead study author Hiroyuki Yoshihara, MD, PhD, an orthopaedic surgeon at State University of New York (SUNY) Downstate Medical Center and Nassau University Medical Center.

According to 2006 U.S. Census Bureau data, Americans who are at least 85 years old represent the fastest-growing population and are expected to account for 2.3 percent of the U.S. population in 2030 and 4.3 percent in 2050. Reflecting this trend, and despite the fact that very elderly patients are at greater risk for post-surgical complications and diminished outcomes due to a greater number of comorbidities (unrelated diseases and conditions), the number of elective orthopaedic surgeries for patients age 80 and older continues to rise.

In the study, researchers analyzed data for patients age 80 and older, and those ages 65 to 79, from the Nationwide Inpatient Sample (NIS). Patient sex, race, comorbidities, complications, mortality, duration of hospital stay, whether or not patients were discharged to their home or to a rehabilitation facility, and total hospital charges were retrieved and analyzed.

Of the patients in the NIS database who were at least 80 years of age, 417,460 underwent TKR; 233,277 THR; and 70,203, spinal fusion between 2000 and 2009. In the 65 to 79 patient range, 1,868,983 underwent TKR; 768,999, THR; and, 522,369, spinal fusion.

Among the findings:

  • Most surgeries in the 80 and older age group involved patients ages 80 to 84: spinal fusion (79.3 percent), THR (68.9 percent) and TKR (73.9 percent).
  • The overall in-hospital complication rate remained stable, declining slightly from 2000 to 2009 in the 80 and older patient group for spinal fusion (from 17.5 percent to 16.1 percent) and for TKR (from 9.9 percent to 9.1 percent). The complication rate increased for THR from 9 percent to 10.3 percent.
  • The overall in-hospital complication rate significantly decreased in patients without a comorbidity, or with a small number of comorbidities, for spinal fusion and TKR; and remained stable in those without a comorbidity, or with a small number of comorbidities, for THR in the 80 and older patient group.
  • The in-hospital mortality rate in the 80 and older age group averaged .9 percent for spinal fusion, .5 percent for THR and .3 percent for TKR.
  • Although the overall in-hospital complication and mortality rates were significantly higher for patients age 80 and older compared to patients age 65 to 79 for all three procedures, the difference was small.

"Despite stable or increased in-hospital complications, the in-hospital mortality rate decreased over time for all three procedures," said Dr. Yoshihara. "I think this finding may reflect improvements in medical treatment for complications during the last decade.

"As life expectancy continues to increase, I hope that very elderly patients who have had inadequate results from exhaustive conservative treatment (for various orthopaedic conditions) undergo the procedures and have better life quality," said Dr. Yoshihara.


Story Source:

The above story is based on materials provided by American Academy of Orthopaedic Surgeons. Note: Materials may be edited for content and length.


Journal Reference:

  1. H. Yoshihara, D. Yoneoka. Trends in the Incidence and In-Hospital Outcomes of Elective Major Orthopaedic Surgery in Patients Eighty Years of Age and Older in the United States from 2000 to 2009. The Journal of Bone & Joint Surgery, 2014; 96 (14): 1185 DOI: 10.2106/JBJS.M.01126

Cite This Page:

American Academy of Orthopaedic Surgeons. "Orthopedic surgery generally safe for patients age 80 and older." ScienceDaily. ScienceDaily, 17 July 2014. <www.sciencedaily.com/releases/2014/07/140717125051.htm>.
American Academy of Orthopaedic Surgeons. (2014, July 17). Orthopedic surgery generally safe for patients age 80 and older. ScienceDaily. Retrieved October 20, 2014 from www.sciencedaily.com/releases/2014/07/140717125051.htm
American Academy of Orthopaedic Surgeons. "Orthopedic surgery generally safe for patients age 80 and older." ScienceDaily. www.sciencedaily.com/releases/2014/07/140717125051.htm (accessed October 20, 2014).

Share This



More Health & Medicine News

Monday, October 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Microneedle Patch Promises Painless Pricks

Microneedle Patch Promises Painless Pricks

Reuters - Innovations Video Online (Oct. 18, 2014) Researchers at The National University of Singapore have invented a new microneedle patch that could offer a faster and less painful delivery of drugs such as insulin and painkillers. Video provided by Reuters
Powered by NewsLook.com
Raw: Nurse Nina Pham Arrives in Maryland

Raw: Nurse Nina Pham Arrives in Maryland

AP (Oct. 17, 2014) The first nurse to be diagnosed with Ebola at a Dallas hospital walked down the stairs of an executive jet into an ambulance at an airport in Frederick, Maryland, on Thursday. Pham will be treated at the National Institutes of Health. (Oct. 16) Video provided by AP
Powered by NewsLook.com
Raw: Cruise Ship Returns to US Over Ebola Fears

Raw: Cruise Ship Returns to US Over Ebola Fears

AP (Oct. 17, 2014) A Caribbean cruise ship carrying a Dallas health care worker who is being monitored for signs of the Ebola virus is heading back to Texas, US, after being refused permission to dock in Cozumel, Mexico. (Oct. 17) Video provided by AP
Powered by NewsLook.com
Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

AFP (Oct. 17, 2014) All four suspected Ebola cases admitted to hospitals in Spain on Thursday have tested negative for the deadly virus in a first round of tests, the government said Friday. Duration: 00:55 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins