Preoperative Factors Associated With Pulmonary Embolism Following Primary Total Hip Arthroplasty: An ACS-NSQIP Analysis of 2017–2021 Data

Background This study examined preoperative factors associated with 30-day pulmonary embolism (PE) after primary total hip arthroplasty. Methods ACS-NSQIP records from 2017–2021 with CPT code 27130 were analyzed. Complete cases were included using cleaned body mass index (BMI), age, sex, steroid use, and disseminated cancer. These five variables were entered jointly into logistic regression. Results Among 196,495 complete cases, 484 (0.246%) had PE. Adjusted odds ratios were 6.44 for disseminated cancer, 1.69 for steroid use, 1.23 for female sex, 1.041 per year of age, and 1.031 per kg/m² of BMI (all P < .05). Apparent AUC was 0.647 (95% CI, 0.622–0.672). The Hosmer–Lemeshow test indicated lack of fit (P = .012). Conclusions Five preoperative characteristics were associated with PE. Discrimination was modest, calibration limitations were present, and validation is required before clinical use.