scholarly journals Comparing Inpatient Complication Rates between Octogenarians and Nonagenarians following Primary and Revision Total Knee Arthroplasty in a Nationally Representative Sample, 2010–2014

Geriatrics ◽  
2018 ◽  
Vol 4 (1) ◽  
pp. 3 ◽  
Author(s):  
Eric Smith ◽  
Evan Dugdale ◽  
David Tybor ◽  
Michael Kain
Keyword(s):  
Acute Kidney Injury ◽  
Total Knee Arthroplasty ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Mortality Rate ◽  
Kidney Injury ◽  
Revision Total Knee Arthroplasty ◽  
Complication Rates ◽  
Inpatient Mortality ◽  
Total Knee

We compared the inpatient postoperative complication rates between octogenarians and nonagenarians undergoing primary and revision total knee arthroplasty (TKA). We used the Nationwide Inpatient Sample (NIS) to analyze inpatient admission data from 2010–2014. We compared the rates at which nonagenarians and octogenarians developed each complication following both primary TKA (PTKA) and revision TKA (RTKA). A national estimate of 324,933 patients were included in our study. A total of 313,299 (96.42%) were octogenarians, and 11,634 (3.58%) were nonagenarians. 294,462 (90.62%) underwent PTKA, and 30,471 (9.38%) underwent RTKA. Nonagenarians undergoing PTKA had a higher inpatient mortality rate, and developed sepsis more frequently than octogenarians. Nonagenarians undergoing RTKA had a higher inpatient mortality rate, and developed cardiogenic shock more frequently than octogenarians. In both PTKA and RTKA, nonagenarians received transfusions more frequently, and developed urinary tract infection and acute kidney injury more frequently than octogenarians. In both PTKA and RTKA, nonagenarians sustained a higher inpatient mortality rate than octogenarians. Orthopedic surgeons should counsel nonagenarian patients undergoing both PTKA and RTKA preoperatively about this increased mortality risk, as well as the increased risks of more minor complications like transfusion, urinary tract infection, and acute kidney injury.

Acute Kidney Injury After Placement of an Antibiotic-Impregnated Cement Spacer During Revision Total Knee Arthroplasty

2012 ◽  
Vol 27 (6) ◽  
pp. 1221-1227.e2 ◽  
Author(s):  
Travis J. Menge ◽  
John R. Koethe ◽  
Cathy A. Jenkins ◽  
Patty W. Wright ◽  
Andrew A. Shinar ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Kidney Injury ◽  
Revision Total Knee Arthroplasty ◽  
Cement Spacer ◽  
Total Knee

scholarly journals Comparing Inpatient Complication Rates between Octogenarians and Nonagenarians Following Primary and Revision Total Hip Arthroplasty in a Nationally Representative Sample 2010–2014

Geriatrics ◽  
2019 ◽  
Vol 4 (4) ◽  
pp. 55 ◽  
Author(s):  
Dugdale ◽  
Tybor ◽  
Kain ◽  
Smith
Keyword(s):  
Acute Kidney Injury ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Total Hip Arthroplasty ◽  
Tract Infection ◽  
Hip Arthroplasty ◽  
Kidney Injury ◽  
Complication Rates ◽  
Revision Total Hip Arthroplasty ◽  
Inpatient Complication

We compared inpatient postoperative complication rates between octogenarians and nonagenarians undergoing primary and revision total hip arthroplasty (THA). We used inpatient admission data from 2010–2014 from the Nationwide Inpatient Sample (NIS). We compared the rates at which nonagenarians and octogenarians developed each complication in the inpatient setting following both primary THA (PTHA) and revision THA (RTHA). A total of 40,944 inpatient admissions were included in our study which extrapolates to a national estimate of 199,793 patients. A total of 185,799 (93%) were octogenarians and 13,994 (7%) were nonagenarians. PTHA was performed on 155,669 (78%) and RTHA was performed on 44,124 (22%) of the patients. Nonagenarians undergoing PTHA required transfusions significantly more frequently (33.13% v. 24.0%, p < 0.001) and developed urinary tract infection (5.14% v. 3.92%, p = 0.012) and acute kidney injury (5.50% v. 3.57%, p < 0.001) significantly more frequently than octogenarians. Nonagenarians undergoing RTHA required transfusions significantly more frequently (51.43% v. 41.46%, p < 0.001) and developed urinary tract infection (19.66% v. 11.73%, p < 0.001), acute kidney injury (13.8% v. 9.66%, p < 0.001), pulmonary embolism (1.24% v. 0.67%, p = 0.031), postoperative infection (1.89% v. 1.11%, p = 0.023), sepsis (3.59% v. 2.43%, p = 0.021) and other postoperative shock (1.76% v. 1.06%, p = 0.036) significantly more frequently than octogenarians. Nonagenarians undergoing RTHA also had a significantly higher inpatient mortality rate (3.28% v. 1.43%, p < 0.001) than octogenarians. Orthopedic surgeons and primary care providers can use these findings to help counsel both their octogenarian and nonagenarian patients preoperatively when considering THA. Our analysis can help these patients better understand expected inpatient complication rates and assist them in deciding whether to pursue surgical intervention when applicable.

scholarly journals Acute kidney injury in kidney rupture and urinary tract infection in A 6-year-old-boy

2017 ◽  
Vol 48 (2) ◽  
pp. 142
Author(s):  
Dinna Auliawati ◽  
Gusti Ayu Putu Nilawati ◽  
I Ketut Suarta ◽  
Wayan Yudiana
Keyword(s):  
Acute Kidney Injury ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Kidney Injury ◽  
Kidney Rupture

Renal diseases and emergencies

2016 ◽  
Author(s):  
Dr Andrew Davenport
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Renal Transplant ◽  
Urinary Tract Obstruction ◽  
Kidney Injury ◽  
Renal Diseases ◽  
Transplant Patients

Chapter 11 discusses diseases and emergencies involving renal medicine, including investigation of the renal tract, acute kidney injury (AKI), haematuria and proteinuria, urinary tract infection (UTI), urinary tract obstruction, tumours of the renal tract, chronic kidney disease (CKD), and renal transplant patients.

scholarly journals Urolithiasis Is a Risk Factor for Uroseptic Shock and Acute Kidney Injury in Patients With Urinary Tract Infection

2019 ◽  
Vol 6 ◽  
Author(s):  
Chih-Yen Hsiao ◽  
Tsung-Hsien Chen ◽  
Yi-Chien Lee ◽  
Meng-Chang Hsiao ◽  
Peir-Haur Hung ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Urinary Tract Infection ◽  
Risk Factor ◽  
Urinary Tract ◽  
Tract Infection ◽  
Kidney Injury

scholarly journals The role of rotating hinge implants in revision total knee arthroplasty

2019 ◽  
Vol 4 (6) ◽  
pp. 269-278 ◽  
Author(s):  
Gilles Pasquier ◽  
Matthieu Ehlinger ◽  
Didier Mainard
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Complication Rates ◽  
Poor General Health ◽  
Joint Reconstruction ◽  
Bone Fixation ◽  
Rotating Hinge ◽  
Total Knee ◽  
Segmental Bone

Hinged implants are the most constrained knee replacement prostheses. They are very useful in complex cases of total knee arthroplasty (TKA) revision. Hinged implants have evolved with rotating bearings and modularity that allows local joint reconstruction or segmental bone replacement. They are required when significant instability persists in cases with inadequate collateral ligaments and significant flexion laxity. They are now used when a large bone defect is reconstructed, or when bone fixation of the implant is questionable especially in the metaphyseal zone. The use of hinged implants in TKA revision is associated with high complication rates. Published outcomes differ based on the patients’ aetiology. The outcomes of rotating-hinged implants used in septic revisions or salvage situations are poorer than other types of revision and have a higher complication rate. The poor general health of these patients is often a limitation. Despite these relatively poor results, hinged implants continue to have a place in revision surgery to solve major instability or to obtain stable bone fixation of an implant when the metaphysis is filled with bone grafts or porous devices.Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180070

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