Impact of COVID-19 on total hip arthroplasty: results from California state inpatient database

Abstract

COVID-19 pandemic has significantly affected orthopedic surgery, resulting in postponements and cancellations. The aim of this study is to determine the possible effects of COVID-19 on the number of total hip arthroplasty (THA) hospitalizations and hospital outcomes using a large database. We conducted a retrospective analysis of data gathered and stored in the California State Inpatient Database (SID) during 2019 and 2020. All THA hospitalizations ≥18 yr that occurred in 2019 and 2020 and COVID-19 hospitalizations that occurred in 2020 were used for the analysis. The primary outcomes of the study were trends in THA hospitalizations between 2019 and 2020. Secondary outcomes were mortality, surgical, medical, and other complications, and prolonged length of stay. A total of 36,760 and 20,243 THA hospitalizations occurred during 2019 and 2020, respectively. Trends in THA hospitalizations during 2019 and 2020 showed that the rates of these hospitalizations were substantially lower throughout 2020. Logistic regression analysis showed that the odds of mortality (odds ratio [OR], 2.77; 95% CI, 1.38-5.53), surgical complications (OR,1.61; 95% CI, 1.36-1.89), medical complications (OR,1.27; 95% CI, 1.20-1.33), other complications (OR,1.42; 95% CI, 1.19-1.69), and prolonged length of stay (OR,1.10; 95% CI, 1.05-1.16) were significantly higher during 2020. Our findings show that during COVID-19 pandemic THA hospitalizations were prioritized based on case severity. By the end of 2020 THA hospitalizations did not steeply decrease in numbers compared to the advent of the pandemic, indicating that orthopedic surgeons and other healthcare professionals functioned optimally even during the COVID-19 pandemic.