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Risk factors of postoperative complications following total knee arthroplasty in Korea: A nationwide retrospective cohort study

Authors
 Min-Seok Ko  ;  Chong-Hyuk Choi  ;  Han-Kook Yoon  ;  Ju-Hyung Yoo  ;  Hyun-Cheol Oh  ;  Jin-Ho Lee  ;  Sang-Hoon Park 
Citation
 MEDICINE, Vol.100(48) : e28052, 2021-12 
Journal Title
MEDICINE
ISSN
 0025-7974 
Issue Date
2021-12
MeSH
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee* / adverse effects ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications / epidemiology* ; Prosthesis-Related Infections ; Pulmonary Embolism ; Retrospective Studies ; Risk Factors ; Sepsis ; Stroke ; Surgical Wound Infection* / epidemiology ; Surgical Wound Infection* / etiology
Abstract
Background: The number of patients undergoing total knee arthroplasty (TKA) is gradually increasing and there is also increase in postoperative complications. The patient's demographic, socio-economic factors, hospital and clinical factors are all factors that can influence postoperative complications. The purpose of this study was to determine the risk factors associated with complications following TKA in a large national cohort.

Methods: Among patients diagnosed with primary knee arthrosis, a total of 560,954 patients older than 50 years who underwent TKA from January 1, 2005 to December 31, 2018 were included in the study. The risk of postoperative complications (surgical site infection, sepsis, cardiovascular complications, respiratory complications, pulmonary embolism, stroke, acute renal failure, periprosthetic joint infection, and periprosthetic fracture) were assessed with eight independent variables: gender, age, place of residence, household income, hospital bed size, procedure type (unilateral or bilateral, primary or revision TKA), length of stay (LOS), use of transfusion. Multivariable Cox Proportional Hazard model analysis was used. The significant predictors for complications (P < .05) were as follows.

Results: Surgical site infection: male, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Sepsis: male, household income, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Cardiovascular complications: male, age, household income, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Respiratory complications: male, household income, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Pulmonary embolism: male, household income, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Stroke: male, age, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Acute renal failure: male, household income, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Periprosthetic joint infection: male, household income, procedure type (bilateral, revision), LOS (≥35 days), transfusion. Periprosthetic fracture: male, procedure type (bilateral, revision), LOS (≥35 days), transfusion.

Conclusion: In summary, male, procedure type (bilateral, revision), LOS (≥35 days), and use of transfusion were shown to be risk factors of postoperative complications following TKA.
Files in This Item:
T202126234.pdf Download
DOI
10.1097/MD.0000000000028052
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Choi, Chong Hyuk(최종혁) ORCID logo https://orcid.org/0000-0002-9080-4904
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190645
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