How many patients have died from complications associated with hip-replacement operations and what the cause of death was in each case in e…

ISD Scotland collects hospital data (SMR01 records) from which hip-replacement operations can be identified, and utilises National Records of Scotland (NRS) data from which causes of death (from the death certificate) can be identified. The Scottish Arthroplasty Project combines these data, but due to quality and completeness of recording it is not possible to definitively identify deaths due to complications from hip-replacement operations.
Table 1 shows the number of patients who have undergone one or more hip-replacement operations from 1999 to 2010 and have a subsequent cause of death, as identified from the death certificate, as a complication due to surgical implant. These figures are likely to slightly underestimate the actual number of deaths, due to the complexities of death in a generally elderly population (those receiving hip implants). It may not always be possible for the certifying doctor to definitively record each and all of the causes of death, and complications due to implants may not always be wholly evident.
Information has been provided for 1999 to 2010 combined instead of by individual year to avoid disclosing small numbers.

Table 1. Number of patients who have undergone one or more hip-replacement operations 1 January 1999 to 31 December 2010 and have a subsequent cause of death as a complication due to surgical implant, with total number of hip operations by NHS board
NHS Board of Treatment
Total Number of Hip Replacement Operations
Total Number of Patients who Have a Subsequent Cause of Death as a Complication due to Surgical Implant
%
NHS Ayrshire and Arran
4,489
28
0.62
NHS Borders
2,084
15
0.72
NHS Dumfries and Galloway
1,503
16
1.06
NHS Fife
4,329
13
0.30
NHS Forth Valley
2,602
13
0.50
NHS Grampian
9,311
31
0.33
NHS Greater Glasgow and Clyde
17,577
82
0.47
NHS Highland
4,318
14
0.32
NHS Lanarkshire
4,645
23
0.50
NHS Lothian
10,783
83
0.77
NHS Tayside
8,810
54
0.61
NHS Western Isles
490
6
1.22
NHS National Waiting Times Unit
5,275
6
0.11
Scotland
76,216
384
0.50
Source: ISD SMR01 data.
1. Table 1 shows the number of instances where a patient has undergone one or more hip-replacement operation (including total hip replacements, revisions, resurfacings, hybrid and emergency operations) from 1999 to 2010, has subsequently died and where the ICD10 code Y83.1 “Surgical operation with implant of artificial internal device as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure” is recorded as a cause of death on NRS data, derived from the death certificate.
2. OPCS4 codes for hip arthroplasty, hip resurfacing, hybrid hip replacement, hip revision or hybrid hip revision have been selected. For further information please see:
http://www.arthro.scot.nhs.uk/OPCS_codes_summary_150710.pdf. Emergency admissions are included.
3. It is possible that a patient may have had an additional implant other than that fitted in the hip-replacement operation, and that it is this from which the complication (noted as cause of death) arose. Without recourse to the patients medical notes, it is not possible to differentiate between multiple implants and subsequent complications as cause of death.
4. Further information on the quality of NRS death data is available here:
http://www.gro-scotland.gov.uk/statistics/theme/vital-events/deaths/bckgr-info/quality-of-nrs-data-on-deaths.html.
5. Further information on the quality of SMR01 data is available here:
http://www.isdscotland.org/Products-and-Services/Data-Quality/.