Incidence and risk factors of postoperative hyperamylasemia and pancreatitis following total knee arthroplasty: a retrospective study

Abstract

Background Postoperative hyperamylasemia and pancreatitis are recognized complications after abdominal and spinal surgeries. The aim of this study is to investigate the incidence and identify risk factors for postoperative hyperamylasemia and pancreatitis following total knee arthroplasty. Methods 170 patients undergoing total knee arthroplasty were retrospectively identified from our database from January 2017 to January 2021. Patients were divided into normal and hyperamylasemia groups based on the presence of serum amylase level within or greater than the normal range. Postoperative pancreatitis was defined as serum amylase level greater than five times above the normal range. Patient demographics, perioperative parameters were investigated with student t test, chi square test and multivariate logistic regression analysis. Results 43 patients (25.3%) exhibited postoperative hyperamylasemia while eight patients (4.7%) developed postoperative pancreatitis. One patient (0.6%) was designated as having clinical pancreatitis. More patients with Hypertriglyceridemia (HTG) were noted in hyperamylasemia group (P = 0.009) compared with normal group. Hyperamylasemia group showed higher preoperative serum amylase (74.95 vs 55.62 IU/L, P < 0.001), higher IBL (117.67 vs 77.01 mL, P = 0.040) and longer surgical duration (132.98 vs 107.01 min, P = 0.041). Multivariate logistic analysis revealed that HTG (OR = 0.189, P = 0.006), preoperative serum amylase (OR = 1.042, P < 0.001) and IBL (OR = 1.004, P = 0.022) were independent risk factors for postoperative hyperamylasemia. Conclusions A significant percentage of patients developed hyperamylasemia after total knee arthroplasty. Patients with HTG, higher preoperative serum amylase and higher IBL had an increased risk of developing postoperative hyperamylasemia and pancreatitis.