Risk factors for in-patient myocardial infarction following total hip arthroplasty

Purpose: The aim of this study was to identify potential risk factors for myocardial infarction immediately following total hip arthroplasty. Methods: The 2016–2019 Nationwide Inpatient Sample database was used to identify patients who underwent primary total hip arthroplasty (THA) and suffered a myocardial infarction (MI). Patient data including demographics, admission, and comorbidities were recorded. Univariate analysis and subsequent multivariate logistic regression were performed to determine which circumstances affected the odds of MI. Results: A total of 367,890 patients were identified for THA with 142 of those also having a myocardial infarction. Those who experienced an MI had increased length of stay, total charges, and generally negative dispositions compared to their non-MI counterparts (p < 0.001). Through regression analysis, factors that increased the odds of MI included older age [odds ratio (OR) 1.59, 95 % confidence interval (CI) 1.49–1.70], a female sex (OR 1.46, 95 % CI 1.37–1.55), previous coronary artery bypass graft (OR 1.20, 95 % CI 1.01–1.43), obesity (OR 1.12, 95 % CI 1.04–1.21), colostomy (OR 2.07, 95 % CI 1.21–3.56), and Parkinson's disease (OR 1.48, 95 % CI 1.13–1.95). Factors that decreased that risk included elective admission (OR 0.21, 95 % CI 0.19–0.22) and a tobacco related disorder (OR 0.69, 95 % CI 0.63–0.76). Conclusions: Patient risk for myocardial infarction following total hip arthroplasty varies in part based on their background and comorbidities. These findings can be used to better recognize those who should receive further precautions and tailor proper treatment strategies for THA.