Perioperative risk factor analysis for mortality in patients undergoing total hip arthroplasty: A national database study from Türkiye

Objective: Mortality is a devastating complication after primary total hip arthroplasty (THA). The aim of this study was to investigate the prevalence and risk factors associated with 1-year postoperative mortality in patients undergoing primary THA.

Methods: The authors reviewed the e-health database (e-Nabız) of the Republic of Türkiye Ministry of Health to identify patients who underwent primary THA between January 2016 and June 2022. The study included 98 622 patients with a mean age of 59.9 Å} 13.6 years. Hip fractures were excluded. Demographic data, body mass index, and Charlson Comorbidity Index scores were recorded. The incidence of 1-year mortality was investigated. A multivariate Cox regression model was created to identify risk factors for 1-year postoperative mortality.

Results: The postoperative 1-year mortality of patients who underwent primary THA was 2.8%. Cox regression analysis revealed that male gender and advanced age were independent risk factors for 1-year mortality and the risk of 1-year mortality increased with comorbidities such as cancer (hazard ratio (HR) = 2.46; 95% CI = 2.21-2.71), renal disease (HR = 2.29; 95% CI = 2.1-2.5), dementia (HR = 1.83; 95% CI = 1.63- 2.05), liver disease (HR = 1.69; 95% CI = 1.25-2.27), heart failure (HR = 1.65; 95% CI = 1.49-1.83), cerebrovascular accident (CVA) (HR = 1.43; 95% CI = 1.3-1.57), and acute myocardial infarction (AMI) (HR = 1.25; 95% CI = 1.07-1.45).

Conclusion: Advanced age, male gender, cancer, renal disease, dementia, liver disease, heart failure, CVA, and AMI were identified as risk factors for 1-year mortality in patients undergoing THA. Meticulous preoperative medical optimization and standardized postoperative care may reduce mortality among patients with these comorbidities.

Cite this article as: Artuç M, Birinci M, Hakyemez ÖS, et al. Perioperative risk factor analysis for mortality in patients undergoing total hip arthroplasty: A national database study from Türkiye. Acta Orthop Traumatol Turc., 2026; 60(2), 0052, doi:10.5152/j.aott.2026.24052.