Age/BMI is a strong predictor of 30-day mortality and morbidity following total hip arthroplasty

TL;DR

This study shows that the Hajeer score, which combines age and BMI, is a strong predictor of 30-day mortality and complications after hip replacement surgery.

Contribution

The Hajeer score is introduced as a more effective predictor of postoperative outcomes than age or BMI alone.

Findings

A higher Hajeer score is strongly linked to increased 30-day mortality and complications.

Age increases the risk of mortality and various postoperative complications.

Higher BMI is associated with lower risk of mortality and some complications.

Abstract

This retrospective cohort study investigated the “Hajeer score” (age/BMI) as a predictor of 30-day postoperative outcomes pertaining to morbidity and mortality following total hip arthroplasty.

Using the National Surgical Quality Improvement Project database from 2011 to 2021, this study analyzed perioperative factors and 30-day postoperative complications in relation to age, BMI, and the Hajeer score. The complications evaluated included venous thromboembolism, pneumonia, acute myocardial infarction, readmission rates, and 30-day mortality. Patients were categorized based on their age, BMI, and Hajeer score and adjusted odds ratios (aORS) for morbidities and mortality were calculated by multivariate logistic regression.

A total of 321,973 patients who underwent total hip arthroplasty were included in this study. Risk of mortality and various other outcomes (including cardiac, respiratory, urinary, and central nervous system diseases, thromboembolism, sepsis, blood transfusion, and composite morbidity) increased with age. Conversely, a higher BMI was linked to a lower risk of mortality, cardiac and respiratory diseases, and blood transfusion. A higher Hajeer score (>3) was strongly associated with an increased risk of mortality [adjusted odds ratio [OR]: 20.06, 95% confidence interval [CI]: 2.81–143.08, p < 0.05], cardiac diseases (adjusted OR: 8.53, 95% CI: 1.19–60.96, p < 0.0001), respiratory diseases (adjusted OR: 1.40, 95% CI: 1.40–1.41, p < 0.0001), and blood transfusion (adjusted OR: 2.12, 95% CI: 1.73–2.60, p < 0.05).

The Hajeer score could be a more effective predictor of short-term (30-day) postoperative outcomes than either age or BMI alone.