Background/Purpose: To assess the time-trends in gender differences in mortality after primary total knee and total hip arthroplasty (TKA and THA) by rural or urban residence.

Methods: We used the Nationwide Inpatient Sample (NIS) data from 1998 to 2010 to examine time-trends by gender in TKA and THA. Rates were calculated for the U.S. population.

Results: Mortality rates were higher in males compared to females through the study period.  In 2003, mortality rates in rural females, rural males, urban females and urban males after primary TKA were: 115, 279, 140 and 230 per 100,000, respectively.  Respective numbers for primary THA were: 326, 346, 360 and 168. In 2010, similar differences were seen by gender in both rural and urban dwelling females and males: (1) urban: 70, 92, 29 and 131; and (2) rural 145, 154, 94, 211, respectively.  In all cohorts, a significant reduction in mortality was noted.  The rate of reduction of mortality over time was most noticeable in rural-dwelling women among all groups.

Conclusion: The mortality rates following primary TKA and THA has decreased significantly over the last 7 years from 2003 to 2010.  Mortality is higher in males compared to females, a difference that has not changed over time.  More insights are need into understanding what factors contribute to lower mortality in females. 

 Table 1. Mortality per 100,000 by gender in rural/urban residents

ACR Meeting Abstracts - https://acrabstracts.org/abstract/higher-mortality-in-males-compared-to-females-undergoing-total-knee-or-total-hip-arthroplasty-a-study-of-national-time-trends-2003-2010/