Inpatient mortality after elective primary total hip and knee joint arthroplasty in Botswana.
PURPOSE
Total hip and knee joint arthroplasty (TJA) rank among the most successful orthopaedic operations. Several developing countries in Africa have started to perform these procedures that are routine in developed countries. The aims of this study were to measure the incidence and assess the determinants of in-hospital mortality after elective primary TJA in our unit and compare it with published data.


METHODS
This was a retrospective study of the first consecutive cohort of patients who underwent elective primary TJA in Princess Marina Hospital, Botswana between March 2009 and October 2015 (6.5 years).


RESULTS
346 elective joint replacements were performed comprising 153 total hip arthroplasties (THA) and 193 total knee arthroplasties (TKA); 36 % of the THA were in female patients and 82 % of TKA were in females. The mean age was 64.5 years (range 26-86). Three patients died giving an inpatient mortality rate of 0.86 %. These three mortalities represent 1.55 % (three out of 193) of all the TKA. There were no deaths after THA. The cause of mortality in two patients was an adverse cardiac event while the third mortality was due to pulmonary embolism.


CONCLUSION
The inpatient mortality rate of 0.86 % following TJA is higher than the reported rates in the developed countries but comparable with data from other developing countries. The inpatient mortality rate following TKA was higher than that following THA and cardiovascular events proved to be the main cause of death. We recommend formal cardiology assessment and close peri-operative monitoring of all patients with a history of cardiovascular disease undergoing TJA.
['Lisenda|Laughter|L|0000-0003-1958-3640', 'Mokete|Lipalo|L|', 'Mkubwa|Joseph|J|', 'Lukhele|Mkhululi|M|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D001168:Arthritis D019644:Arthroplasty, Replacement, Hip D019645:Arthroplasty, Replacement, Knee D001902:Botswana D017558:Elective Surgical Procedures D005260:Female D006331:Heart Diseases D017052:Hospital Mortality D006801:Humans D015994:Incidence D008297:Male D008875:Middle Aged D011655:Pulmonary Embolism D012189:Retrospective Studies
Inpatient mortality Developing country Hip and knee replacement