CHANGES IN MORTALITY AFTER TOTAL HIP AND KNEE ARTHROPLASTY OVER A 10-YEAR PERIOD

A retrospective review of in-hospital mortality after total hip and to tal knee arthroplasty was performed to determine whether extensive cha nges in anesthesia care, introduced in this institution in July 1986, were associated with changes in mortality rates. From 1981 to 1985, th e mortality rate was 0.39% (23 of 5874 patients) and from 1987 to 1991 , the mortality rate was 0.10% (10 of 9685 patients) (P = 0.0003). Sig nificant reductions in mortality rate were observed for both total hip arthroplasty (from 0.36% to 0.10%) (P = 0.0277) and total knee arthro plasty (from 0.44% to 0.10%) (P = 0.0131). The mortality rate of 0.10% is significantly less than previously published rates. Marked changes in anesthesia management were associated with a significant reduction in mortality after total hip and knee arthroplasty.