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ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1531104
This article is part of the Research Topic Advances in Surgical and Basic Research in Hip Surgery: Complications, Artificial Intelligence and Surgery Robotics View all 3 articles
Age/BMI is a Strong Predictor of 30-Day Mortality and Morbidity Following Total Hip Arthroplasty
Provisionally accepted
Hana M.A. Fakhoury 1,2*
Mohamad Nasser Eddine 3 Hani Tamim 2,3
Ziad A Memish 2 Muhammad Affan Elahi 2
Sarah Daher 2
Ali H. Hajeer 4- 1 Alfaisal University, Riyadh, Saudi Arabia
- 2 College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- 3 American University of Beirut, Beirut, Beirut, Lebanon
- 4 King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Introduction: This retrospective cohort study investigated the "Hajeer score" (age/BMI) as a predictor of 30day postoperative outcomes pertaining to morbidity and mortality following total hip arthroplasty.Methods: Using the National Surgical Quality Improvement Project database from 2011 to 2021, this study analyzed perioperative factors and 30-day postoperative complications in relation to age, BMI, and the Hajeer score. The complications evaluated included venous thromboembolism, pneumonia, acute myocardial infarction, readmission rates, and 30-day mortality. Patients were categorized based on their age, BMI, and Hajeer score and adjusted odds ratios (aORS) for morbidities and mortality were calculated by multivariate logistic regression.Results: A total of 321,973 patients who underwent total hip arthroplasty were included in this study. Risk of mortality and various other outcomes (including cardiac, respiratory, urinary, and central nervous system diseases, thromboembolism, sepsis, blood transfusion, and composite morbidity) increased with age.Conversely, a higher BMI was linked to a lower risk of mortality, cardiac and respiratory diseases, and blood transfusion. A higher Hajeer score (>3) was strongly associated with an increased risk of mortality (adjusted odds ratio [OR]: 20.06, 95% confidence interval [CI]: 2.81-143.08, p <0.05), cardiac diseases (adjusted OR:
Keywords: Hajeer Score, Total hip arthroplasty, postoperative outcomes, Preoperative risk stratification, Short-term
Received: 19 Nov 2024; Accepted: 04 Mar 2025.
Copyright: © 2025 Fakhoury, Nasser Eddine, Tamim, Memish, Elahi, Daher and Hajeer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hana M.A. Fakhoury, Alfaisal University, Riyadh, Saudi Arabia
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