Incidence of and Risk Factors for 30-Day Readmission Following Elective Primary Total Joint Arthroplasty: Analysis From the ACS-NSQIP

2013 ◽  
Vol 28 (9) ◽  
pp. 1499-1504 ◽  
Author(s):  
Andrew J. Pugely ◽  
John J. Callaghan ◽  
Christopher T. Martin ◽  
Peter Cram ◽  
Yubo Gao
Keyword(s):  
Risk Factors ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Acs Nsqip

The Incidence And Risk Factors of Serum Hypokalemia After Primary Total Joint Arthroplasty

2021 ◽  
Author(s):  
Pin Pan ◽  
Zitao Zhang ◽  
Xiaofeng Zhang ◽  
Qing Jiang ◽  
Zhihong Xu
Keyword(s):  
Risk Factors ◽  
Red Blood Cells ◽  
Knee Replacement ◽  
Serum Potassium ◽  
Total Joint Arthroplasty ◽  
Blood Cells ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
Joint Arthroplasty ◽  
Regular Monitoring

Abstract Background: Regular monitoring of serum potassium after total joint arthroplasty (TJA) is a routine examination, which can detect abnormal serum potassium and reduce adverse events timely caused by postoperative hypokalemia. In this study, we aimed to investigate the incidence and risk factors of hypokalemia after primary total hip and knee replacement.Methods: This study included patients who underwent unilateral total knee or hip arthroplasty in our department from April 2017 to March 2018. The serum potassium level before and after operation was collected and retrospectively analyzed. The differences in age, BMI and other factors between hypokalemia patients and non-hypokalemia patients at different time points after surgery were compared, and then the risk factors of postoperative hypokalemia were analyzed based on multiple logistic regression.Results: The total incidence of postoperative hypokalemia was 53.1%, while the respective rate on the first, third and fifth postoperative day was 12.5%, 40.7% and 9.6%. The serum potassium level on the first, third and fifth postoperative day was 3.84±0.32mmol/l, 3.59±0.34mmol/l and 3.80±0.32mmol/l, while among which, the level on the third day was the lowest (p=0.015). The independent risk factors for hypokalemia after total hip and knee replacement were the level of preoperative serum potassium (p=0.011), preoperative red blood cells (p=0.027), and a history of diabetes (p=0.007).Conclusion: Regular monitoring of serum potassium should be performed after TJA due to hypokalemia was a very common complication. We need to pay more attention to patients’ preoperative potassium and red blood cells, especially patients with diabetes.

scholarly journals Risk Factors for Surgical Site Infection Following Total Joint Arthroplasty

2014 ◽  
Vol 96 (18) ◽  
pp. e158-1-5 ◽  
Author(s):  
Mohammad R Rasouli ◽  
Camilo Restrepo ◽  
Mitchell G Maltenfort ◽  
James J Purtill ◽  
Javad Parvizi
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Site Infection

scholarly journals Risk Factors for Transfusions Following Total Joint Arthroplasty in Patients With Rheumatoid Arthritis

2018 ◽  
Vol 24 (8) ◽  
pp. 422-426 ◽  
Author(s):  
Elizabeth Salt ◽  
Amanda T. Wiggins ◽  
Mary Kay Rayens ◽  
Katelyn Brown ◽  
Kate Eckmann ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty

The Most Significant Risk Factors for Urinary Retention in Fast-track Total Joint Arthroplasty are Iatrogenic

2019 ◽  
Vol 34 (1) ◽  
pp. 136-139 ◽  
Author(s):  
Mohamad J. Halawi ◽  
Nicholas Caminiti ◽  
Mark P. Cote ◽  
Adam D. Lindsay ◽  
Vincent J. Williams
Keyword(s):  
Risk Factors ◽  
Urinary Retention ◽  
Total Joint Arthroplasty ◽  
Fast Track ◽  
Significant Risk ◽  
Joint Arthroplasty

Should postoperative haemoglobin and potassium levels be checked routinely following blood-conserving primary total joint arthroplasty?

2019 ◽  
Vol 101-B (1_Supple_A) ◽  
pp. 25-31 ◽  
Author(s):  
N. J. Greco ◽  
A. G. Manocchio ◽  
A. V. Lombardi ◽  
S. L. Gao ◽  
J. Adams ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Total Joint Arthroplasty ◽  
Laboratory Data ◽  
Joint Arthroplasty ◽  
Renal Diseases ◽  
Study Cohort ◽  
Blood Conservation ◽  
Potassium Supplementation ◽  
History Of

Aims Despite declining frequency of blood transfusion and electrolyte supplementation following total joint arthroplasty, postoperative blood analyses are still routinely ordered for these patients. This study aimed to determine the rate of blood transfusion and electrolyte restoration in arthroplasty patients treated with a perioperative blood conservation protocol and to identify risk factors that would predict the need for transfusion and electrolyte supplementation. Patients and Methods Patients undergoing primary total joint arthroplasty of the hip or knee between July 2016 and February 2017 at a single institution were included in the study. Standard preoperative and postoperative laboratory data were collected and reviewed retrospectively. A uniform blood conservation programme was implemented for all patients. Need for blood transfusion or potassium supplementation was determined through a coordinated decision by the care team. Rates of transfusion and supplementation were observed, and patient risk factors were noted. Results The overall rate of blood transfusion was 1.06% in the study population of 1132 total joint arthroplasties performed in 1023 patients. Of the 12 patients requiring transfusion, 11 were female, ten occurred in patients undergoing total hip arthroplasty, and all 12 patients had a preoperative haemoglobin level less than 130 g/l. Operative duration and surgical blood loss were significantly greater in those patients requiring blood transfusion. Nearly all patients requiring transfusion had a history of, or risk factors for, cardiovascular disease. Potassium supplementation was required in 15.5% of the study cohort; 72% of these patients receiving potassium presented with a potassium level less than 4 mmol/l during preoperative testing, while the remaining 28% had a past medical history of either significant anaemia, cardiopulmonary, cardiovascular, or renal diseases that had required substantial medical management. Conclusion A consistent blood-conserving perioperative strategy effectively minimized need for blood transfusion in total joint arthroplasty patients below previously reported rates in the literature. We suggest that postoperative full blood counts and basic metabolic panels should not routinely be ordered in these patients unless their preoperative haemoglobin and potassium is below 130 g/dl or 4 mmol/l respectively, and they have medical comorbidities.

scholarly journals 350. Outcomes for Joint Arthroplasty in Persons Living with HIV

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S185-S185
Author(s):  
Charisse L Mandimika ◽  
Lydia A Barakat ◽  
Marjorie Golden
Keyword(s):  
Risk Factors ◽  
Total Joint Arthroplasty ◽  
Academic Medical Center ◽  
Joint Arthroplasty ◽  
Adverse Outcomes ◽  
Smoking History ◽  
Modifiable Risk Factors ◽  
Post Surgery ◽  
Persons Living With Hiv ◽  
Living With Hiv

Abstract Background Persons living with HIV (PLHIV) now have dramatically improved life-expectancy with age-related morbidities requiring total joint arthroplasties. We present here an institutional review of PLHIV who underwent total joint arthroplasty and prosthesis-related adverse outcomes at one year. Methods This was a retrospective chart review in a large academic medical center. Inclusion criteria were adult PLHIV undergoing total joint arthroplasty between 2013 and 2017. Arthroplasty-related adverse outcomes within the first-year post-surgery were recorded. Patients were identified using ICD-10 codes and classified as having a PJI using Infectious Diseases Society of America (IDSA) criteria. Results A total of 40 patients met the criteria. The median age was 59 years and 53% of patients were male. The median CD4 count and RNA viral load were 587 (range 94–1920) cells/mm3 and 0 (range 0—189,000) copies/mL, respectively. The most common procedure was hip replacement (55%) and the most common indication for arthroplasty was avascular necrosis (43%). Adverse outcomes including PJI, dislocation, prosthesis loosening, seroma and chronic pain were identified in 28% of patients. PJI occurred in two patients and both required surgical revision. Modifiable risk factors present in both patients were active smoking, history of substance use disorder, chronic pulmonary disease, depression and hepatitis C antibody positivity. Both patients had CD4 counts >600 cells/mm3. Both were on atazanavir containing antiretroviral regimens. Neither patient was screened for MRSA carriage. Causal organisms were MRSA and MSSA respectively and each patient received 6 weeks of antimicrobial therapy. Conclusion This study supports that when medically optimized, PLHIV have favorable outcomes. The two patients who developed PJI had multiple non-HIV modifiable risk factors predisposing them to PJI. In one case, the patient’s isolated organism was MRSA, for which the patient did not receive appropriate pre-operative antimicrobial prophylaxis. This highlights the importance of routine screening for appropriate pre-operative prophylaxis in patients undergoing joint arthroplasty, independent of HIV status. Disclosures All authors: No reported disclosures.

scholarly journals What Are Risk Factors for Infection after Primary or Revision Total Joint Arthroplasty in Patients Older Than 80 Years?

2020 ◽  
Vol 478 (8) ◽  
pp. 1741-1751
Author(s):  
Nipun Sodhi ◽  
Hiba K. Anis ◽  
Rushabh M. Vakharia ◽  
Alexander J. Acuña ◽  
Peter A. Gold ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Revision Total Joint Arthroplasty
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