Primary knee arthroplasty in Sweden: A nationwide analysis of all-cause 30-day mortality and impact of age and ASA-class.

Abstract

Knee arthroplasty is one of the most common orthopaedic procedures in Sweden, which is in line with many other countries in the Western world. There is no recent data on all-cause 30-day mortality associated with primary knee arthroplasty in Sweden during recent years. The purpose of the present observational quality register study was to investigate the mortality at 0, 7, 30 and 90 days after primary knee arthroplasty, and the impact of age and ASA-class. Data from SPOR (Swedish PeriOperative Registry) on primary knee arthroplasty (ICD code NGB) registered between 2017 and 2021 in patients ≥18 years was analysed. Perioperative mortality rates and impact of age and ASA were analysed and are presented as numbers, proportions and 95% confidence interval. The study cohort included 35,794 patients. The study found overall low 30-day mortality rate, 16 out of 35,794 patients (0.045%, 95% confidence Interval 0.027%-0.071%), no patients died on the day of surgery, six died within one week, while 50 died within 90 days, with no significant differences over the years. High age and higher ASA-class were associated with higher mortality. The study showed a low and stable 30-day mortality associated with primary knee arthroplasty at 0.045%. Age above 80 years and ASA-Classes III and IV were associated with increased mortality rate, the benefit versus risk in relation to knee arthroplasty procedure should be assessed individually in patients above 80 years and ASA-Classes III and IV. Not applicable.