Effect of frailty on hospital outcomes following total hip arthroplasty

Abstract

Frailty is characterized by decreased physiological reserves and impaired functioning of multiple systems. This study investigated the association between frailty and hospital outcomes such as postoperative complications, length of hospital stays, readmission rates, and functional outcomes following THA. Data for this study were retrieved from the Nationwide Inpatient Sample (NIS) database, 2018–2021. Adult patients 18 years and above with a primary diagnosis of THA were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-10-CM) codes. We identified frail patients using the Hospital Frailty Risk Score (HFRS). The main outcomes of this study were surgical complications, medical complications, in-hospital mortality, and prolonged length of stay. There were 1,725,550 THA hospitalizations, of which 9.1% (156,275) were frail. Logistic regression analysis showed that frailty was associated with significantly greater odds of surgical complications (OR, 4.77, 95% CI: 4.27–5.33), medical complications (OR, 2.68, 95% CI: 2.59–2.76), other complications (OR, 8.13, 95% CI: 7.53–8.78), any complications (OR, 3.17, 95% CI: 3.08–3.27), mortality (OR, 2.74, 95% CI: 1.99–3.54), and prolonged length of stay (OR, 5.25, 95% CI: 5.05–5.45). Frailty significantly impacts postoperative outcomes in patients undergoing THA, leading to increased complications, in-hospital mortality, and prolonged hospital stays. A proactive approach for managing frailty could lead to better resource utilization and enhanced recovery following THA.