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Letters to the Editor   |    
Thirty-Day Mortality Following Hip Arthroplasty
Christopher G. Moran, MD, FRCS1
1 University HospitalNottingham NG7 2UHUnited Kingdomanne.hay@qmc.nhs.uk
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The author did not receive grants or outside funding in support of his research or preparation of this work. He did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the author is affiliated or associated.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2005 Mar 01;87(3):680-680
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To The Editor:I read with great interest the article entitled "Thirty-Day Mortality Following Hip Arthroplasty for Acute Fracture" (2004; 86:1983-8), by Drs. Parvizi, Ereth, and Lewallen. I would be grateful for some more detail on the calculation of thirty-day mortality.Thirty-day mortality should only be calculated when the status (i.e., dead or alive) is known for each patient in the cohort or population thirty days after the index event. Complete follow-up of the entire cohort is required for this calculation. A thirty-day mortality of 2.4% is remarkably low for a population of elderly patients with hip fractures, particularly as the background mortality (death by natural causes) is 0.8% per month. Were the authors calculating inhospital mortality, rather than true thirty-day mortality? This is an important issue if mortality rates are to be compared between institutions as the low mortality rate quoted by the authors could have been due to a relatively short hospital stay with early rehabilitation in the community. Reductions in length of stay also may explain the decrease in mortality over the past three decades.
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