Hip Pelvis.  2021 Dec;33(4):231-238. 10.5371/hp.2021.33.4.231.

The Association of Alcohol Use Disorder with Perioperative Complications following Primary Total Hip Arthroplasty

Affiliations
  • 1Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA
  • 2Department of Orthopaedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY, USA

Abstract

Purpose
Alcohol use disorder is a leading mental health disorder in the United States. Few studies evaluating the association of alcohol use disorder following primary total hip arthroplasty (THA) have been reported. Therefore, the purpose of this study was to determine whether patients with alcohol use disorder undergoing primary THA have higher rates of: 1) in-hospital lengths of stay (LOS); 2) complications (medical/implant-related); and 3) costs.
Materials and Methods
Using a nationwide claims database from January 1st, 2005 to March 31st, 2014, patients with alcohol use disorder undergoing primary THA were identified and matched to a comparison group according to age, sex, and various comorbidities, resulting in 230,467 patients who were included in the study (n=38,416) and a matched-cohort (n=192,051). Outcomes of interest included comparison of LOS, 90-day medical and 2-year implant-related complications, and costs. A P-value less than 0.002 was considered statistically significant.
Results
Patients with alcohol use disorder had longer in-hospital LOS (4 days vs 3 days; P<0.0001) as well as higher frequency and odds ratio (OR) of 90-day medical (45.94% vs 12.25%; OR, 2.89; P<0.0001) and 2-year implant-related complications (17.71% vs 8.46%; OR, 1.97; P<0.0001). Patients in the study group incurred higher 90-day costs of care ($17,492.63 vs $14,921.88; P<0.0001).
Conclusion
With the growing prevalence of alcohol use disorder in the United States, the current investigation can be utilized to evaluate the need for interventions prior to THA which can potentially minimize the rates of morbidity and mortality within this population.

Keyword

Alcohol use disorder; Total hip arthroplasty; Postoperative complications; Cost and costs analysis
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