Mortality after elective total hip arthroplasty in elderly Americans. Age, gender, and indication for surgery predict survival.

Medicare Part A claims records were used to determine the perioperative mortality and cumulative postoperative survival of elderly Americans undergoing total hip arthroplasty (THA) for reasons other than hip fracture. The indication for THA was determined by analysis of the diagnosis codes in the claims records. Perioperative mortality was 0.95% (48/5078) and increased with age, from 0.34% (three of 872) in those 66 years to 69 years of age to 3.75% (nine of 240) among those 85 years of age or older. Perioperative mortality was not related to race, gender, or the indication for which the surgery was performed. Among these elderly patients not operated on for hip fracture, cumulative survival after surgery increased with decreasing age, female gender, and when osteoarthrosis was the indication for surgery. Persons undergoing THA had better survival after surgery than the age-gender-matched general population. Perioperative mortality among elderly Americans undergoing THA in the community is low and similar to that estimated by the 1982 NIH Consensus Conference, which considered primarily data reported from referral centers.