TY  - JOUR
T1  - Ninety-Day Mortality After Total Elbow Arthroplasty
AU  - Sanchez-Sotelo, Joaquin
AU  - Sperling, John W.
AU  - Morrey, Bernard F.
Y1  - 2007/07/01
N1  - 10.2106/JBJS.F.00651
JO  - The Journal of Bone & Joint Surgery
SP  - 1449
EP  - 1451
VL  - 89
IS  - 7
N2  - Background: Perioperative mortality, although seldom mentioned and
rare after upper-extremity surgery, is one of the potential complications of
total elbow arthroplasty. The purpose of this study was to determine the
prevalence and risk factors associated with perioperative mortality after
elbow arthroplasty.Methods: The records of 1117 consecutive patients who had undergone
1441 total elbow arthroplasties at our institution between 1970 and 2002 were
reviewed to identify patients who had died within ninety days after the
procedure. A detailed analysis of the medical, surgical, anesthetic, and
pathologic records of these patients was performed.Results: The ninety-day mortality rate was 0.62% (nine of 1441
cases). Seven of the patients who died were female and two were male; their
mean age at the time of surgery was sixty-six years. An underlying diagnosis
of distal humeral fracture (including pathologic fracture) or nonunion was
associated with an increased risk of death (p < 0.001). Seven patients died
after primary arthroplasty and two, after revision arthroplasty. The average
time from surgery to death was forty-five days. The causes of death were
congestive heart failure (three patients) and myocardial infarction, acute
heart embolus, respiratory failure, pneumonia, renal failure, and bleeding
secondary to gastric stress ulcer (one patient each). All patients had
substantial comorbidities.Conclusions: The rate of perioperative mortality after total elbow
arthroplasty is low. Most patients who die after this procedure are elderly,
have substantial comorbidities, and underwent the total elbow arthroplasty for
the treatment of a traumatic or pathologic distal humeral fracture or
nonunion.Level of Evidence: Prognostic Level II. See Instructions
to Authors for a complete description of levels of evidence.
SN  - 0021-9355
M3  - doi: 10.2106/JBJS.F.00651
UR  - http://dx.doi.org/10.2106/JBJS.F.00651
ER  -