Table 2

GRADE summary of findings for total hip arthroplasty

ComplicationsAnticipated absolute effects* (95% CI)Relative effect
(95% CI)
Participants
(studies) (n)
Certainty of the evidence
(GRADE)
Risk with no PNBRisk with PNB
Mortality1 per 1000 1 per 1000
(0 to 1)
OR 0.61
(0.36 to 1.04)
342 826
(2 observational studies)
⨁◯◯◯
very low†
Cardiac without MI21 per 1000 18 per 1000
(16 to 20)
OR 0.84
(0.76 to 0.93)
342 941
(1 RCT, 2 observational studies)
⨁⨁◯◯
low
MI7 per 1000 7 per 1000
(1 to 50)
OR 1.00
(0.14 to 7.19)
277
(2 RCTs)
⨁⨁⨁◯
moderate†
Pulmonary11 per 1000 7 per 1000
(6 to 9)
OR 0.70
(0.60 to 0.81)
343 198
(4 RCTs, 2 observational studies)
⨁⨁⨁◯
moderate‡
Respiratory failure174 per 1000 71 per 1000
(35 to 135)
OR 0.36
(0.17 to 0.74)
357
(3 RCTs, 1 observational studies)
⨁⨁⨁⨁
high†
Pneumonia17 per 1000 6 per 1000
(0 to 128)
OR 0.33
(0.01 to 8.35)
115
(1 RCT)
⨁⨁⨁◯
moderate†
Gastrointestinal5 per 1000 3 per 1000
(2 to 3)
OR 0.55
(0.43 to 0.70)
342 841
(1 RCT, 1 observational study)
⨁⨁⨁◯
moderate
Renal15 per 1000 10 per 1000
(9 to 12)
OR 0.67
(0.59 to 0.76)
342 826
(2 observational studies)
⨁⨁◯◯
low
Renal failure20 per 1000 7 per 1000
(0 to 144)
OR 0.33
(0.01 to 8.21)
100
(1 observational study)
⨁◯◯◯
very low*¶
Delirium157 per 1000 53 per 1000
(31 to 90)
OR 0.30
(0.17 to 0.53)
723
(5 RCTs, 1 observational study)
⨁⨁⨁⨁
high
Stroke1 per 1000 1 per 1000
(1 to 1)
OR 0.83
(0.53 to 1.29)
342 726
(1 observational study)
⨁◯◯◯
very low†
Surgical site infection12 per 1000 7 per 1000
(6 to 8)
OR 0.55
(0.47 to 0.64)
343 091
(2 RCTs, 2 observational studies)
⨁⨁⨁⨁
high
Any infection25 per 1000 18 per 1000
(17 to 20)
OR 0.71
(0.65 to 0.78)
342 841
(1 RCT, 1 observational study)
⨁⨁◯◯
low
Sepsis20 per 1000 6 per 1000
(1 to 60)
OR 0.32
(0.03 to 3.16)
203
(1 RCT, 1 observational study)
⨁⨁⨁◯
moderate†
Thromboembolism3 per 1000 3 per 1000
(2 to 3)
OR 0.74
(0.58 to 0.96)
342 955
(3 RCTs, 1 observational study)
⨁⨁⨁◯
moderate†
Perioperative nerve injury7 per 1000 4 per 1000
(2 to 8)
OR 0.62 (0.30 to 1.27)11 118
(2 observational studies)
⨁⨁◯◯
low
Blood transfusion194 per 1000 168 per 1000
(166 to 171)
OR 0.84
(0.83 to 0.86)
873 079
(3 RCTs, 2 observational studies)
⨁⨁⨁◯
moderate†
Blood lossMD 10.61 lower
(4.28 lower to 25.50 higher)
454
(8 RCTs, 1 observational studies)
⨁⨁⨁◯
moderate†
Critical care admission76 per 1000 70 per 1000
(66 to 73)
OR 0.91
(0.86 to 0.95)
342 885
(1 RCT, 1 observational study)
⨁⨁◯◯
low
Length of stayMD 0.36 lower
(0.42 lower to 0.31 lower)
872
(7 RCTs, 4 observational studies)
⨁⨁⨁◯
moderate§
  • *The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

  • †Optimal Information Size (OIS) low.

  • ‡Funnel plot one-sided.

  • §Heterogeneity detected (I2 high).

  • ¶Risk of bias suspected.

  • GRADE, Grading of Recommendations Assessment, Development, and Evaluation; MD, mean difference; MI, myocardial infarction; PNB, peripheral nerve block; RCT, randomized controlled trial.