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Table 4 Results for mortality

From: Is there an optimal age for total knee arthroplasty?: A systematic review

Author Journal Year Number Age (years) Result
Difference
 Murphy [14] Bone Joint J 2018 2838 < 80,
≥ 80
Mortality hazard ratio in ≥ 80-years group is 3.40 (2.54–4.54, P < 0.001)
 Skinner [37] Ann R Coll Surg Eng 2016 67 70–79,
90–99
Mortality rates were higher in the nonagenarian group but these were in keeping with the life expectancy projections identified by the Office for National Statistics
 Shah [20] J knee Surg 2016 33,066 < 65,
≥ 65
Young cohort had lower rate of mortality (0.03 vs. 0.18%, P < 0.001)
 Jauregui [39] J Arthroplast 2015 35,342 < 90,
≥ 90
Serious postoperative adverse events that were significantly higher in nonagenarians compared to controls included death (0.9% vs. 0.2%; P = 0.024)
 Maempel [40] Acta Orthop 2015 3144 < 75,
75–80,
> 80
Odds ratios for mortality at 1 year, adjusted for ASA, were 2.2 (1.0–4.5) for age 75–80, and 3.0 (1.3–6.8) for age > 80, relative to age < 75 years
 Belmont [42] J Bone Joint Surg Am 2014 15,321   Patient age (OR = 1.12; 95% CI, 1.06 to 1.17) was independent predictor of mortality
 D’Apuzzo [43] J Arthroplast 2014 5,492,805 < 90,
≥ 90
In-hospital mortality was significantly higher in the older cohort compared to the younger group (2.9% versus 0.2%; P < 0.001)
 Easterlin [46] Clin Orthop Rel Res 2013 8950 40–64,
65–69,
70–74,
75–79,
80–84,
85–89
Age was associated with increased risk of mortality starting at age 85 years; mortality in patients 85 years and older was 17 times higher than in those younger than 65 years (OR: 70–74 (1.21), 75–79 (2.85), 80–84 (2.57), 85–89 (17.65)
 Kennedy [48] Clin Orthop Rel Res 2013 ≥ 80: 438
< 80: 2754
< 80,
≥ 80
Octogenarians had a higher (P < 0.001) mortality rate in Kaplan-Meier survival analysis
 Jämsen [51] Acta Orthop 2012 1998 75–79,
80–84,
≥ 85
Adjusted hazard ratio for age 75–79 years is 1, for 80–84 years it is 1.71 [1.31–2.23], for 85 years or over it is 3.34 (2.39–4.65)
 Singh [52] J Arthroplast 2012 12,484   Older age was associated with higher 90-day all-cause mortality. OR for age (per 5-year increase) is 1.6 (1.3–1.9) in univariate analysis and 1.6 (1.2–1.7) in multivariable-adjusted analysis
 Kreder [59] J Arthroplast 2005 15,029 65–79,
> 80
Patients > 80 years of age are 3.4 times more likely to die
No difference
 Kuo [44] J Orthop Surg Res 2014 1024 < 80,
≥ 80
There was no 90-day mortality in either group
 Robertsson [58] Bone Joint J 2007 57,979 < 54,
55–59,
60–64,
65–69,
70–74,
75–79,
80–84,
> 85
Patients younger than 55 years had a statistically significant increase in total mortality (standardized mortality ratio: 1.85 [1.53–2.22]) while patients older than 65 years had a statistically significant decrease
  1. OR odds ratio