GRADE summary of findings for total hip arthroplasty
| Complications | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | Participants (studies) (n) | Certainty of the evidence (GRADE) | |
| Risk with no PNB | Risk with PNB | ||||
| Mortality | 1 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 MI | 21 per 1000 |
18 per 1000
(16 to 20) |
OR 0.84
(0.76 to 0.93) | 342 941 (1 RCT, 2 observational studies) | ⨁⨁◯◯ low |
| MI | 7 per 1000 |
7 per 1000
(1 to 50) |
OR 1.00
(0.14 to 7.19) | 277 (2 RCTs) | ⨁⨁⨁◯ moderate† |
| Pulmonary | 11 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 failure | 174 per 1000 |
71 per 1000
(35 to 135) |
OR 0.36
(0.17 to 0.74) | 357 (3 RCTs, 1 observational studies) | ⨁⨁⨁⨁ high† |
| Pneumonia | 17 per 1000 |
6 per 1000
(0 to 128) |
OR 0.33
(0.01 to 8.35) | 115 (1 RCT) | ⨁⨁⨁◯ moderate† |
| Gastrointestinal | 5 per 1000 |
3 per 1000
(2 to 3) |
OR 0.55
(0.43 to 0.70) | 342 841 (1 RCT, 1 observational study) | ⨁⨁⨁◯ moderate |
| Renal | 15 per 1000 |
10 per 1000
(9 to 12) |
OR 0.67
(0.59 to 0.76) | 342 826 (2 observational studies) | ⨁⨁◯◯ low |
| Renal failure | 20 per 1000 |
7 per 1000
(0 to 144) |
OR 0.33
(0.01 to 8.21) | 100 (1 observational study) | ⨁◯◯◯ very low*¶ |
| Delirium | 157 per 1000 |
53 per 1000
(31 to 90) |
OR 0.30
(0.17 to 0.53) | 723 (5 RCTs, 1 observational study) | ⨁⨁⨁⨁ high |
| Stroke | 1 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 infection | 12 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 infection | 25 per 1000 |
18 per 1000
(17 to 20) |
OR 0.71
(0.65 to 0.78) | 342 841 (1 RCT, 1 observational study) | ⨁⨁◯◯ low |
| Sepsis | 20 per 1000 |
6 per 1000
(1 to 60) |
OR 0.32
(0.03 to 3.16) | 203 (1 RCT, 1 observational study) | ⨁⨁⨁◯ moderate† |
| Thromboembolism | 3 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 injury | 7 per 1000 |
4 per 1000
(2 to 8) | OR 0.62 (0.30 to 1.27) | 11 118 (2 observational studies) | ⨁⨁◯◯ low |
| Blood transfusion | 194 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 loss | MD 10.61 lower
(4.28 lower to 25.50 higher) | – | 454 (8 RCTs, 1 observational studies) | ⨁⨁⨁◯ moderate† | |
| Critical care admission | 76 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 stay | MD 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.