Impact of comorbid conditions on outcomes of hip and knee replacement surgery: a systematic review and meta-analysis

BMJ Open
Bélène PodmoreSujith Konan

Abstract

To systematically perform a meta-analysis of the association between different comorbid conditions on safety (short-term outcomes) and effectiveness (long-term outcomes) in patients undergoing hip and knee replacement surgery. Systematic review and meta-analysis. Medline, Embase and CINAHL Plus were searched up to May 2017. We included all studies that reported data to allow the calculation of a pooled OR for the impact of 11 comorbid conditions on 10 outcomes (including surgical complications, readmissions, mortality, function, health-related quality of life, pain and revision surgery). The quality of included studies was assessed using a modified Newcastle-Ottawa Scale. Continuous outcomes were converted to ORs using the Hasselblad and Hedges approach. Results were combined using a random-effects meta-analysis. The primary outcome was the adjusted OR for the impact of each 11 comorbid condition on each of the 10 outcomes compared with patients without the comorbid condition. Where the adjusted OR was not available the secondary outcome was the crude OR. 70 studies were included with 16 (23%) reporting on at least 100 000 patients and 9 (13%) were of high quality. We found that comorbidities increased the short-term risk of ho...Continue Reading

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Citations

Jul 11, 2020·BMC Musculoskeletal Disorders·Jorge Arias-de la TorreMireia Espallargues
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Nov 18, 2021·Archives of Orthopaedic and Trauma Surgery·Kara M McConaghyNicolas S Piuzzi

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