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Background: Comorbid chronic obstructive pulmonary disease (COPD) is increasingly common and may have an adverse impact on outcomes in patients undergoing total joint arthroplasty (TJA) of lower extremity. The purpose of this meta-analysis is to compare the postoperative complications between COPD and non-COPD patients undergoing primary TJA including total hip and knee arthroplasty. Methods: PubMed, EMBASE, and Cochrane Library were systematically searched for relevant studies published before December 2021. Postoperative outcomes were compared between patients with COPD versus those without COPD as controls. The outcomes were mortality, re-admission, pulmonary, cardiac, renal, thromboembolic complications, surgical site infection (SSI), periprosthetic joint infection (PJI), and sepsis. Results: A total of 1,002,779 patients from nine studies were finally included in this meta-analysis. Patients with COPD had an increased risk of mortality (OR [odds ratio] = 1.69, 95% confidence interval [CI] 1.42–2.02), re-admission (OR = 1.54, 95% CI 1.38–1.71), pulmonary complications (OR = 2.73, 95% CI 2.26–3.30), cardiac complications (OR = 1.40, 95% CI 1.15–1.69), thromboembolic complications (OR = 1.21, 95% CI 1.15–1.28), renal complications (OR = 1.50, 95% CI 1.14–1.26), SSI (OR = 1.23, 95% CI 1.18–1.30), PJI (OR = 1.26, 95% CI 1.15–1.38), and sepsis (OR = 1.36, 95% CI 1.22–1.52). Conclusion: Patients with comorbid COPD showed an increased risk of mortality and postoperative complications following TJA compared with patients without COPD. Therefore, orthopedic surgeons can use the study to adequately educate these potential complications when obtaining informed consent. Furthermore, preoperative evaluation and medical optimization are crucial to minimizing postoperative complications from arising in this difficult-to-treat population. Level of evidence: Level III. Registration: None.

For the comprehensive estimation of regional climate change over East Asia (EA) at the 2 and 3 °C global warming levels (GWLs), the Köppen‐Trewartha climate‐type change is assessed with ensemble regional climate change projections in line with Coordinated Regional Climate Downscaling Experiment (CORDEX)‐EA phase 2. Under the 2 °C (3 °C) GWL, 17.6% (25.2%) of the EA region is expected to undergo major climate‐type changes. Tropical and subtropical climate types will expand northward, accompanied by increasing hydroclimatic intensity. Limiting GWL to 2 °C shows benefits by preventing subtropical‐type expansion around far EA. Desertification over inland regions of EA exhibits scenario dependency. Boreal and tundra climate types over high‐latitude regions will tend to decrease rapidly, especially over the Tibetan Plateau. The results are expected to be a baseline assessment of climate change over EA under the 2 and 3 °C GWLs above the preindustrial level. This paper investigates the Köppen‐Trewartha climate‐type changes over East Asia (EA) at the 2 and 3 °C global warming levels (GWLs) with the ensemble regional climate simulations. Under the 2 °C (3 °C) GWL, 17.6% (25.2%) of the EA region is expected to undergo major climate‐type changes. The result shows increased tropical, subtropical, and desert climate types accompanied by intensification of hydroclimatic stress. In addition, boreal and tundra climate types over high‐latitude regions will tend to decrease rapidly, especially over the Tibetan Plateau under the 2 and 3 °C GWLs. Baseline assessment of climate change over East Asia under the 2 and 3 °C global warming is here presentedOf the East Asia region, 17.6% (25.2%) is expected to experience major climate‐type changes under the 2 and 3 °C global warmingThe changes are accompanied by intensified hydroclimatic stress and have statistically significant trends until the end of the 21st century