Impact of atrial fibrillation on postoperative outcomes after total knee arthroplasty–A retrospective study

Long, Gong; Suqin, Sun; Geng, Lanlan; Yang, Wei; Zhen-hu, Wang

doi:10.1016/j.jos.2016.05.002

Cited by 18 publications

(6 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With an increasing prevalence of sleep apnoea, this is an important area of future research [54, 55]. Chronic kidney disease has also been shown to be a significant predictor of cardiac complication (OR 5.5; CI 95% 1.68–9.39; p = 0.002), as has atrial fibrillation (OR 2.4; CI 95% 2.1–2.8; p < 0.0046) [56, 57]. Therefore, it is evident that, whilst this systematic review provides an extensive evaluation on the current literature, there are several other relevant studies, which did not meet our inclusion criteria.…”

Section: Discussionmentioning

confidence: 99%

Risk factors associated with cardiac complication after total joint arthroplasty of the hip and knee: a systematic review

et al. 2019

View full text Add to dashboard Cite

BackgroundCardiac complication represents a major cause of morbidity and mortality after total joint arthroplasty, thus necessitating investigation into the associated risks in total hip arthroplasty and total knee arthroplasty. There remains a lack of clarity for many risk factors in the current literature. The aim of this systematic review is to assess the most recent published literature and identify the risk factors associated with cardiac complication in total hip arthroplasty and total knee arthroplasty.MethodsScopus, PubMed, CINHAL, and Cochrane were searched to identify studies published since 2008 reporting on risk factors associated with cardiac complication in elective primary in total hip arthroplasty and total knee arthroplasty in patients ≥18 years old with osteoarthritis. Reported odds ratios, hazard ratios, and relative risk were the principal summary measures collected. The included studies were too heterogeneous to enable meta-analysis.ResultsFifteen studies were included in this systematic review. Increasing age and history of cardiac disease were found by most studies to be positively associated with risk of cardiac complication. There was no strong association found between obesity and cardiac complication. The evidence for other risk factors was less clear in the examined literature, although there is suggestive evidence for male gender and cerebrovascular disease increasing risk.ConclusionsIncreasing age and history of cardiac disease increases the risk of cardiac complication after total hip arthroplasty and total knee arthroplasty. Other risk factors commonly attributed to increased risk in non-cardiac surgery including hypertension and obesity require further evaluation in arthroplasty.Systematic review registrationA detailed protocol was published in the PROSPERO database (registration number CRD42018095887) for this systematic review.Electronic supplementary materialThe online version of this article (10.1186/s13018-018-1058-9) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk factors associated with cardiac complication after total joint arthroplasty of the hip and knee: a systematic review

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Numerous studies have assessed the risk factors associated with the development of VTEs after total joint arthroplasty [15], [16], [17], [18]. Parvizi et al.…”

Section: Discussionmentioning

confidence: 99%

What are the incidence and risk factors of in-hospital mortality after venous thromboembolism events in total hip and knee arthroplasty patients?

et al. 2018

View full text Add to dashboard Cite

BackgroundPulmonary embolism and deep vein thrombosis, together referred to as venous thromboembolism (VTE), are serious and potentially preventable complications after total hip arthroplasty and total knee arthroplasty. The aim of this study was to investigate the incidence of mortality after VTE events and assess the risk factors that are associated with it.MethodsThe Nationwide Inpatient Sample was used to estimate the total number of total hip arthroplasty, total knee arthroplasty, VTE events, and mortality using the International Classification of Diseases, Ninth Revision procedure codes from 2003 to 2012. Patients' demographics, Elixhauser, and Charlson comorbidity indices were used to identify the risk factors associated with in-hospital VTEs and mortality.ResultsA total of 1,805,621 THAs and TKAs were included. The overall rate of VTE was 0.93%. The in-hospital mortality rate among patients with VTEs was 7.1% vs 0.30% in patients without VTEs (P-value < .0001). The risk factors for mortality after VTE events in descending order were as follows: hypercoagulable state (odds ratio [OR]: 5.3, 95% confidence interval [CI]: 3.6-5.8), metastatic cancer (OR: 5.2, 95% CI: 3.3-5.6), myocardial infarction (OR: 4.2, 95% CI: 2.3-4.7), peripheral vascular disease (OR: 3.6, 95% CI: 3.2-4.0), cardiac arrhythmias (OR: 3.2, 95% CI: 1.6-4.3), advanced age (OR: 3.1, 95% CI: 2.3-3.7), electrolyte disorders (OR: 3.1, 95% CI: 2.2-3.6), pulmonary circulation disorders (OR: 2.9, 95% CI: 2.6-3.3), depression (OR: 2.8, 95% CI: 1.6-3.4), complicated diabetes (OR: 2.7, 95% CI: 2.1-3.2), weight loss (OR: 2.6, 95% CI: 2.2-3.3), renal failure (OR: 2.6, 95% CI: 1.7-3.5), chronic pulmonary disease (OR: 2.5, 95% CI: 1.3-3.1), valvular disease (OR: 2.4, 95% CI: 1.8-2.7), liver disease (OR: 1.7, 95% CI: 1.2-1.9), and obesity (OR: 1.6, 95% CI: 1.5-1.9).ConclusionsIn-hospital VTE has a significant in-hospital mortality rate. Several of the identified risk factors in this study are modifiable preoperatively. We strongly urge the orthopaedic community to be cognizant of these risk factors and emphasize on optimizing patients' comorbidities before an elective arthroplasty.

show abstract

“…Data were extracted from the electronic health record, including age, race, sex, BMI, and the presence or absence of the following comorbidities coded in the electronic health record at the time of surgery: diabetes mellitus (type 1 or 2), COPD, atrial fibrillation (AFIB), congestive heart failure (CHF), coronary artery disease (CAD), end-stage renal disease or chronic kidney disease, gastroesophageal reflux disease (GERD), anxiety or depression, and primary hypertension (HTN). These comorbidities were selected for inclusion based on previous literature demonstrating their association with increased complications and LOS after TJA [19][20][21][22][23][24][25][26][27][28][29][30]. A full list of International Classification of Disease 10th Edition codes used to identify the various comorbidities is included in Appendix A.…”

Section: After Exempt Determination From the Institutional Clinicalmentioning

confidence: 99%

Preoperative Predictors of Same-Day Discharge After Total Knee Arthroplasty

et al. 2021

View full text Add to dashboard Cite

Background: In January 2020, The Centers for Medicare and Medicaid Services approved total knee arthroplasty (TKA) to be performed in ambulatory surgery centers (ASCs). This study aims to develop a predictive model for targeting appropriate patients for ASC-based TKA. Methods: A retrospective review of 2266 patients (205 same-day discharge [SDD; 9.0%] and 2061 oneday length of stay [91.0%]) undergoing TKA at a regional medical center between July 2016 and September 2020 was conducted. Multiple logistic regression was used to evaluate predictors of SDD, as these patients represent those most likely to safely undergo TKA in an ASC. Results: Controlling for other demographics and comorbidities, patients with the following characteristics were at reduced odds of SDD: increased age (odds ratio [OR] ¼ 0.935, P < .001), body mass index !35 (OR ¼ 0.491, P ¼ .002), female (OR ¼ 0.535, P < .001), nonwhite race (OR ¼ 0.456, P ¼ .003), primary hypertension (OR ¼ 0.710, P ¼ .032), !3 comorbidities (OR ¼ 0.507, P ¼ .002), American Society of Anesthesiologists score !3 (OR ¼ 0.378, P < .001). The model was deemed to be of adequate fit using the Hosmer and Lemeshow test (c 2 ¼ 12.437, P ¼ .112), and the area under the curve was found to be 0.773 indicating acceptable discrimination. Conclusion: For patients undergoing primary TKA, increased age, body mass index !35, female gender, nonwhite race, primary hypertension, !3 comorbidities, and American Society of Anesthesiologists score !3 decrease the likelihood of SDD. A predictive model based on readily available patient presentation and comorbidity characteristics may aid surgeons in identifying patients that are candidates for SDD or ASC-based TKA.

show abstract

Impact of atrial fibrillation on postoperative outcomes after total knee arthroplasty–A retrospective study

Cited by 18 publications

References 20 publications

Risk factors associated with cardiac complication after total joint arthroplasty of the hip and knee: a systematic review

Risk factors associated with cardiac complication after total joint arthroplasty of the hip and knee: a systematic review

What are the incidence and risk factors of in-hospital mortality after venous thromboembolism events in total hip and knee arthroplasty patients?

Preoperative Predictors of Same-Day Discharge After Total Knee Arthroplasty

Contact Info

Product

Resources

About