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Table 4 Cox ‘proportional hazards’ regression model to compare 90-day mortality between the 7 approach subgroups. Models from Table 3 were also adjusted for Charlson comorbidity subgroups, which were based on HES inpatient admissions within 5 years prior to date of primary THR operation

From: The effect of surgical approach in total hip replacement on outcomes: an analysis of 723,904 elective operations from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man

Approach

Minimally invasive procedure used

(i) With covariate adjustment for sex, age, ASA, year of primary, fixation, mechanical and chemical thromboprophylaxis, anaesthetic group and Charlson comorbidity subgroups, stratified by ‘risk group’ (n = 578,624 with complete information; 2205 deaths) hazard rate ratio [95%CI]

(ii) With covariate adjustment for sex, age, ASA, year of primary, fixation, mechanical and chemical thromboprophylaxis, anaesthetic group, Charlson comorbidity subgroups and quintile of area deprivation, stratified by ‘risk group’ (n = 572,719 with complete information; 2192 deaths) hazard rate ratio [95%CI]

(iii) With covariate adjustment for sex, age, ASA, year of primary, fixation, mechanical and chemical thromboprophylaxis, anaesthetic group, Charlson comorbidity subgroups, quintile of area deprivation and BMI subgroup, stratified by ‘risk group’ (n = 359,883 with complete information; 1148 deaths) hazard rate ratio [95%CI]

Posterior

No

1 [referent]

1 [referent]

1 [referent]

Posterior

Yes

0.94 [0.69–1.28] P = 0.705

0.94 [0.69–1.28] P = 0.678

0.86 [0.56–1.33] P = 0.499

Lat/Ant-Lat/Hard

No

1.13 [1.04–1.24] P = 0.007

1.12 [1.02–1.23] P = 0.013

1.16 [1.02–1.31] P = 0.022

Lat/Ant-Lat/Hard

Yes

0.89 [0.59–1.34] P = 0.579

0.88 [0.59–1.33] P = 0.555

0.81 [0.42–1.57] P = 0.539

Ant/Other

No

0.96 [0.76–1.21] P = 0.726

0.96 [0.76–1.21] P = 0.706

0.90 [0.64–1.27] P = 0.549

Ant/Other

Yes

1.29 [0.64–2.59] P = 0.473

1.32 [0.66–2.65] P = 0.435

1.10 [0.35–3.42] P = 0.872

Trans-trochanteric

No

1.15 [0.77–1.73] P = 0.486

1.15 [0.77–1.71] P = 0.506

1.16 [0.54–2.50] P = 0.701

Additional pairwise comparisons:

Lat/Ant-Lat/Hard

No vs Yes

P = 0.247

P = 0.253

P = 0.296

Ant/Other

No vs Yes

P = 0.425

P = 0.386

P = 0.741

  1. Lat/Ant-Lat/Hard lateral/anterolateral/Hardinge, Ant/Other anterior/other, ASA American Society of Anesthesiologists Physical Status, BMI body mass index, CI confidence interval
  2. *There were no 90-day deaths for human immunodeficiency virus so this was not included in the analysis