MORTALITY AND FATAL PULMONARY-EMBOLISM AFTER PRIMARY TOTAL HIP-REPLACEMENT - RESULTS FROM A REGIONAL HIP REGISTER

We calculated the rates for perioperative mortality and fatal pulmonar y embolism (PE) after primary total hip replacement in a single UK hea lth region, using a regional arthroplasty register and the tracing ser vice of the Office of National Statistics, During 1990, there were 211 1 consecutive primary replacements in 2090 separate procedures, Within 42 days of operation a total of 19 patients had died (0.91%, 95% CI 0 .55 to 1.42). Postmortem examination showed, that four deaths (0.19%, 95% CI 0.05 to 0.49) were definitely doe to PE. The overall perioperat ive mortality and fatal PE rates are low and in our study did not appe ar to be altered by the use of chemical thromboprophylaxis (perioperat ive mortality rate: one-tailed Fisher's exact test, p = 0.39; fatal PE rate: one-tailed Fisher's exact test, p = 0.56). The routine rise of chemical thromboprophylaxis for primary THR is still controversial. Th e issue should be addressed by an appropriate randomised, prospective study using overall mortality and fatal PE rate as the main outcome me asures, but the feasibility of such a study is questioned.