Dialysis Patients Undergoing Total Knee Arthroplasty Have Significantly Increased Odds of Perioperative Adverse Events Independent of Demographic and Comorbidity Factors

The Journal of Arthroplasty
Taylor D OttesenJonathan N Grauer

Abstract

The prevalence of dialysis-dependent patients is growing, and an increasing number of these patients are being considered for total knee arthroplasty (TKA). Studies assessing the preoperative risk associated with TKA in this population are limited to institutional cohorts with small sample sizes or national inpatient databases that lack follow-up data. The 2006-2015 National Surgical Quality Improvement Program databases were queried for adult patients undergoing elective TKA. Differences in 30-day any/severe/minor adverse event, need for reoperation, readmission, and mortality were compared for dialysis-dependent and nondialysis TKA patients using risk-adjusted logistic regression. To account for the smaller number of dialysis patients and variations in study populations, coarsened exact matching was used. The proportion of adverse events that occurred before vs after discharge was also assessed. In total, 250 dialysis-dependent patients and 163,560 nondialysis patients met inclusion criteria. After controlling for patient demographics (age, sex, body mass index, functional status) and overall health (American Society of Anesthesiologists class), matched analysis revealed dialysis-dependent patients to be significantly more li...Continue Reading

Citations

Nov 5, 2020·Regional Anesthesia and Pain Medicine·Harry T MaiGildasio S De Oliveira
May 15, 2020·The Journal of the American Academy of Orthopaedic Surgeons·Kareem J KebaishHarpal Khanuja
Jun 23, 2020·The Journal of the American Academy of Orthopaedic Surgeons·Taylor D OttesenJonathan N Grauer
Mar 16, 2021·Journal of Clinical Orthopaedics and Trauma·Ryan LeeJoseph R O'Brien
May 29, 2021·Journal of Orthopaedics·Ioannis GkiatasPeter K Sculco
Jul 28, 2021·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Ryan LeeRajeev Pandarinath

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