Patients Who Have a Prior History of Pulmonary Embolism Require Increased Postoperative Care Following Total Joint Arthroplasty.
J Arthroplasty
; 39(5): 1245-1252, 2024 May.
Article
in En
| MEDLINE
| ID: mdl-37924988
ABSTRACT
BACKGROUND:
This study examined the effect of prior pulmonary embolism (PE) on total joint arthroplasty (TJA) outcomes.METHODS:
We reviewed patients who had a prior PE undergoing TJA at a single tertiary medical center between January 1, 2012 and January 1, 2021. There were 177 TJA patients who had a prior PE who underwent 13 propensity-matching to patients without a history of prior PE. Bivariable and multivariable analyses were performed. Changes over time were evaluated.RESULTS:
Patients undergoing total knee arthroplasty who had a prior PE had more complications (25.3% versus 2.0%, P < .001), and postoperative PE (17.3% versus 0.0%, P < .001).and longer hospitalizations (3.15 versus 2.32 days, P = .006). Patients undergoing total hip arthroplasty who had a prior PE demonstrated more complications (14.7% versus 1.77%, P < .001) more postoperative PE (17.3% versus 0.0%, P < .001), and longer hospitalizations (3.30 versus 2.11 days, P < .001). Over the study, complication rates and hospitalizations lengths remained elevated in patients who had a prior PE. On multivariate analyses, prior PE was associated with longer hospitalizations (ß 0.67, P = .015) and increased complications (odds ratio [OR] 9.44, P < .001) among total hip arthroplasty patients. Total knee arthroplasty patients had increased readmission (OR 4.89, P = .003) and complication rates (OR 21.4, P < .001).CONCLUSIONS:
Patients undergoing TJA who had a prior PE are at higher risk of requiring postoperative care. Therefore, thorough preoperative evaluation must be implemented, especially in clinical environments lacking resources for acute care escalation.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
J Arthroplasty
Journal subject:
ORTOPEDIA
Year:
2024
Type:
Article