Operative time greater than 120 minutes is associated with increased pulmonary and thromboembolic complications following revision total hip arthroplasty.

backgroundThe aim of this study was to determine the impact of operative time on the development of early postoperative complications in patients undergoing revision total hip arthroplasty (THA).

methodsIn this retrospective cohort study, data were collected through the American College of Surgeons National Quality Improvement Program Database. All patients who underwent revision THA between 2007 and 2016 were identified and stratified into groups based on operative time|: 0-60 min, 61-120 min, 121-180 min, and > 180 min. The incidence of early postoperative adverse events with 30 days, including cardiac, pulmonary, renal, septic, thromboembolic, urinary tract, and wound complications, death, length of stay > 7 days, and unplanned return to the operating room were collected. The complications rates following revision THA were evaluated with univariate and multivariate analyses with significance set at p < 0.05.

resultsA total of 6271 revision THA patients were included for analysis. Patients who had > 120 min of operative time had a significantly increased risk of the development of pulmonary (OR: 1.339; 95% CI: 1.08-1.661; p = 0.008) and thromboembolic complications (OR: 1.34; 95% CI: 1.053-1.707; p = 0.017) and also had an extended length of stay greater than 7 days (OR: 1.413; 95% CI: 1.295-1.541; p < 0.001).

conclusionsIncreased operative time (> 120 min) during revision THA is associated with increased risk of pulmonary and thromboembolic complications, and prolonged hospitalizations (greater than seven days).