Mortality Rates Chopped in Half Due to…Data?

Because they have a national registry, researchers in the UK have learned that mortality after hip and knee replacement surgery in England, Wales and Northern Ireland has dropped by half in the eight years since 2003. Zasia Kmietowjcz, writing for the British Medical Journal (BMJ), reports that 90-day mortality rates after hip replacements fell from 0.56% in 2003 to 0.29% in 2011. The 45-day mortality rates after knee replacement fell from 0.37% to 0.2% over the same period.

The 10-year revision rates for hip and knee replacements are now less than 5%. Rates vary according to age, with younger patients more likely to need to have an implant replaced. The National Joint Registry holds data on more than 1.6 million cases of joint replacement, which it has been collecting since 2003. Doctors replaced 2205, 686 hips, knees and shoulders in 2013.

The UK also has a National Hip Fracture Database which reveals the care given to 64, 938 hip fracture patients in England, Wales and Northern Ireland. It found that the average 30-day mortality in 2013 was 8.05%, down from 8.1% in 2011-12. That amounted to 300 fewer people dying within 30 days of fracturing their hip.

Martyn Porter, MB ChB FRCS(Ed) FRCS Ed(Orth), the registry’s medical director, said, “Whilst standards in British orthopaedics are high, I must encourage my colleagues to scrutinize and engage with National Joint Registry data on a regular basis to evaluate where additional benefits for patients can be maximized.”