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

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.

Outcomes of total hip and knee arthroplasty in special populations: a synopsis and critical appraisal of systematic reviews

“…Those who misused alcohol were found to be 15 times more likely to develop any acute postoperative infection compared to controls [ 29 ]. These findings are in agreement with those of two recent retrospective studies, one in THA and the other in TKA, both showing significantly higher LOS, increased odds of medical complications (including venous thromboembolism), two-year implant-related complications and healthcare costs [ 30 , 31 ]. Low to moderate alcohol consumption, on the other hand, was associated with lower rates of 90-day and one-year mortality as well as 30-day cardiovascular disease after THA or TKA compared to abstainers [ 32 ].…”

Current pathogens infecting open fracture tibia and their antibiotic susceptibility at a tertiary care teaching hospital in South East Asia

“…Furthermore, studies have found that drinking alcohol has little effect on wound infection [ 33 , 34 ]. Alcohol use disorder may, however, play a role, but none of our subjects had this illness [ 35 ].…”

Active Amphetamine Abuse in Total Hip Arthroplasty Carries Increased Risk for Postoperative Surgical and Medical Complications

“…This study demonstrates the high-risk profile of amphetamine abuse for THA outcomes, which is similar to risks seen in alcohol misuse and tobacco use. In one study of nationwide claims data assessing outcomes following THA, patients with alcohol misuse had longer LOS (4 days vs 3 days, P < .0001) and higher risk of 90-day medical complications (45.94% vs 12.25%; OR, 2.89, P < .0001) and 2-year implant-related complications (17.71% vs 8.46%; OR, 1.97, P < .0001) [ 8 ]. Tobacco use, on the other hand, has been shown to carry a higher risk for infection requiring revision surgery (OR 1.54, 95% CI 1.25-1.91) via meta-analysis [ 9 ], as well as have higher risk for postoperative medical complications and increased mortality [ 10 ].…”