Early post-operative mortality following primary total hip replacement.

A study was undertaken to determine the excess risk of death following primary total hip replacement (THR). All patients who underwent THR or were placed on the waiting list for THR during an 18-month period were studied as to their mortality. The dates of all deaths among both of these populations, and age- and sex-specific mortality rates for the Scottish population, were obtained from the Registrar General for Scotland. It was possible to determine a mortality rate for those patients operated upon and those patients who waited 1 year for their operation. The crude mortality rate, standardized mortality ratio (SMR) and excess risk of death were calculated for the patients operated upon. The crude mortality rate was 1.8% and the SMR was 45.5 for the operated-upon group. The excess risk of death associated with THR within the first 3 post-operative months was calculated in two ways. The relative mortality ratio was determined to be 2.37, and the comparative mortality ratio was calculated to be 1.6 for the operated-upon population. Patients selected for THR are in general fitter than average, and the excess risk of death in the first 3 post-operative months after THR is of the order of 1.6.