Back to Search
Start Over
Bilateral total knee arthroplasty: risk factors for major morbidity and mortality.
- Source :
-
Anesthesia and analgesia [Anesth Analg] 2011 Oct; Vol. 113 (4), pp. 784-90. Date of Electronic Publication: 2011 Jul 13. - Publication Year :
- 2011
-
Abstract
- Background: Bilateral total knee arthroplasty (BTKA) performed during the same hospitalization carries increased risk for morbidity and mortality compared with the unilateral approach. However, no evidence-based stratifications to identify patients at risk for major morbidity and mortality are available. Our objective was to determine the incidence and patient-related risk factors for major morbidity and mortality among patients undergoing BTKA.<br />Methods: Nationwide Inpatient Survey data collected for the years 1998 to 2007 were analyzed and cases of elective BTKA procedures were included. Patient demographics, including comorbidities, were analyzed and frequencies of mortality and major complications were computed. Subsequently, a multivariate analysis was conducted to determine independent risk factors for major morbidity and mortality.<br />Results: Included were 42,003 database entries, representing an estimated 206,573 elective BTKAs. The incidence of major in-hospital complications and mortality was 9.5%. Risk factors for adverse outcome included advanced age (odds ratios [ORs] for age groups 65-74 and >75 years were 1.88 [confidence interval, CI: 1.72, 2.05] and 2.66 [CI: 2.42, 2.92], respectively, compared with the 45-65 years group), male gender (OR: 1.54 [CI: 1.44, 1.66]), and a number of comorbidities. The presence of congestive heart failure (OR: 5.55 [CI: 4.81, 6.39]) and pulmonary hypertension (OR: 4.10 [CI: 2.72, 6.10]) were the most significant risk factors associated with increased odds for adverse outcome.<br />Conclusions: We identified patient-related risk factors for major morbidity and mortality in patients undergoing BTKA. Our data can be used to aid in the selection of patients for this procedure.
- Subjects :
- Adult
Age Factors
Aged
Comorbidity
Elective Surgical Procedures
Female
Heart Failure mortality
Humans
Hypertension, Pulmonary mortality
Logistic Models
Male
Middle Aged
Odds Ratio
Patient Selection
Retrospective Studies
Risk Assessment
Risk Factors
Sex Factors
Time Factors
Treatment Outcome
United States epidemiology
Arthroplasty, Replacement, Knee adverse effects
Arthroplasty, Replacement, Knee mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1526-7598
- Volume :
- 113
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Anesthesia and analgesia
- Publication Type :
- Academic Journal
- Accession number :
- 21752942
- Full Text :
- https://doi.org/10.1213/ANE.0b013e3182282953