Acute kidney injury is associated with increased healthcare utilization, complications, and mortality after primary total knee arthroplasty

Therapeutic Advances in Musculoskeletal Disease
Jasvinder A Singh, John D Cleveland

Abstract

The objective of this study was to assess healthcare utilization and complications associated with acute kidney injury (AKI) in patients undergoing primary total knee arthroplasty (TKA). We used the 1998-2014 US National Inpatient Sample to assess whether AKI is associated with healthcare utilization or in-hospital postoperative complications post-TKA using multivariable-adjusted logistic regression analyses. We calculated odds ratios (ORs) and a 95% confidence intervals (CIs). Sensitivity analyses additionally adjusted for hospital characteristics (location/teaching status, bed size, and region). Of the 8,127,282 people who underwent primary TKA from 1998 to 2014, 104,366 (1.3%) had a diagnosis of AKI. People with AKI had longer unadjusted mean hospital stay, 6.1 versus 3.5 days, higher mean hospital charges, US$71,385 versus US$42,067, and higher rates of all in-hospital postoperative complications, including mortality. Adjusted for age, sex, race, underlying diagnosis, medical comorbidity, income, and insurance payer, AKI was associated with a significantly higher OR (95% CI) of total hospital charges above the median, 2.76 (2.68, 2.85); length of hospital stay > 3 days, 2.21 (2.14, 2.28); and discharge to a rehabilitation f...Continue Reading

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