Hereditary hemochromatosis (HH) may lead to iron deposition-mediated arthropathy, causing progressive joint degeneration, necessitating replacement arthroplasty. Studies have noted an increased need for replacement arthroplasty in patients with HH. We aimed to compare the use of replacement arthroplasty and inpatient economic burden in patients with and without HH.
For our retrospective cohort study, we used the 2014 Nationwide Inpatient Sample. Patients with an International Classification of Diseases, Ninth Revision code for HH were included. The primary outcome was use of replacement arthroplasty; secondary outcomes were hospital length of stay, hospital costs, and total hospitalization charges. Multivariate logistic regression yielded confounder-adjusted odds ratios (ORs) and means.
Of 18,250 patients with HH, 7,483 (41.0%) were women and 1,155 (6.3%) underwent replacement arthroplasty. Mean (SD) age for patients with HH and arthroplasty was 66 (18) years. The percentage of patients with HH who underwent replacement arthroplasty was higher than those without HH (3.4%; P<.01). On multivariate analysis, young-adult females and elderly patients with HH were more likely to undergo replacement arthroplasty compared to those without HH of the corresponding gender and age group. Mean length of stay, hospital costs, and total hospitalization charges were increased only in young adult females.
HH is associated with increased odds of replacement arthroplasty, particularly in the elderly, which can potentially suggest faster arthropathy progression in this age group and should raise awareness in clinicians taking care of patients with HH. Future research should identify factors mediating arthropathy progression in patients with HH.