Among patients with cirrhosis, inpatient orthopedic procedures result in high postoperative mortality, length of stay (LOS), and costs, a recent study found. Researchers performed an analysis of the Nationwide Inpatient Sample from 2005 to 2011 for patients undergoing hip arthroplasty, knee arthroplasty, and spinal laminectomy/fusion, stratified by presence of cirrhosis. The primary endpoint was in-hospital mortality. They found:

• There were 696,610 inpatient stays for orthopedic procedures during the study period, with 3,014 (0.43%) patients having cirrhosis.
• Patients with cirrhosis had a lower median age and were more likely to be male.
• The inpatient mortality rate was significantly higher in patients with cirrhosis, as was median LOS and mean costs.
• On multivariable analysis, cirrhosis was associated with an increased risk of mortality (odds ratio, 4.22).
• Hospital cirrhosis volume was inversely associated with mortality.