The risk of death from digestive diseases seems to increase after hip and knee replacements, according to a major analysis published today.
Researchers analysed a large database of hip and knee replacement patients and found some important predictors of post-operative complications and death.
Professor Ashley Blom, of Bristol University, UK, led the team. They examined the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man, identifying 56,568 deaths following 717,025 hip and knee replacement procedures for osteoarthritis over a nine-year period from 2003 to 2012.
This confirmed previous findings that the most common complications leading to death relate to the heart.
But it also showed a marked increase in digestive disease related death in the 90 days following hip and knee replacement. This finding "needs clinical consideration", the team believes.
Professor Blom said: "It is important to remember that joint replacement is one of the most highly effective and cost effective interventions offered to patients with osteoarthritis.
"The chance of dying following joint replacement remains very low and has halved during the time the National Joint Registry has been collecting data, although older patients and males have higher death rates.
"This study has been carried out to better understand what clinical decisions and strategies could be taken to even further reduce the risk of death and enhance a patient’s outcome following joint replacement."
Although the cardiovascular risk was predictable, Professor Blom says: "The increased risk of digestive system related deaths was unexpected."
He urges clinicians to be aware of this and anticipate problems such as intestinal bleeds, obstructions and perforations.
At-risk patients "may require additional preventative strategies and a more rigorous post-operative monitoring and care plan," he recommends.
The study is published today (5 April).
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