Hospital Volume and Outcomes of Total Hip Arthroplasty in the United States

The purpose of this study was to examine the effect of hospital volume on outcomes for primary and revision total hip arthroplasty (THA). The Nationwide Inpatient Sample database was used to identify our patient set. Outcome variables included inhospital mortality and prolonged length of stay. Primary THA mortality was 0.16% in the highest volume quartile and 0.29% in the lowest volume quartile (P < .001). The rates of prolonged length of stay showed improved outcomes in the highest volume hospitals. Similar trends were found for revision THA, with an inhospital mortality of 1.20% for lowest-volume hospitals and 0.48% for highest-volume hospitals (P < .001). Hospitals with higher volume had superior inpatient outcomes for THA and revision arthroplasty.