Dataset Information

The Impact of Hospital Exposures Prior to Total Knee Arthroplasty on Postoperative Outcomes.

ABSTRACT:

Background

Total knee arthroplasty (TKA) procedures are expected to grow exponentially in the upcoming years, highlighting the importance of identifying preoperative risk factors that predispose patients to poor outcomes. The present study sought to determine if preoperative healthcare events (PHEs) influenced outcomes following TKA.

Methods

This was a retrospective review of all patients who underwent TKA at a single institution from June 2011 to April 2022. Patients who had a PHE within 90 days of surgery, defined as an emergency department visit or hospital admission, were compared to patients with no history of PHE. Patients who underwent revision, nonelective, and/or bilateral TKA were excluded. Chi-squared analysis and independent sample t-tests were used to determine significant differences between demographic variables. All significant covariates were included in binary logistic regressions used to predict discharge disposition, 90-day readmission, and 1-year revision.

Results

Of the 10,869 patients who underwent TKA, 265 had ≥1 PHE. Patients who had a PHE were significantly more likely to require facility discharge (odds ratio [OR]: 1.662; P = .001) than patients who did not have a PHE. Any PHE predisposed patients to significantly higher 90-day readmission rates (OR: 2.173; P = .002). Patients with ≥2 PHEs were at a significantly higher risk of 1-year revision (OR: 5.870; P = .004) compared to patients without a PHE.

Conclusions

Our results demonstrate that PHEs put patients at significantly greater risk of facility discharge, 90-day readmission, and 1-year revision. Moving forward, consideration of elective surgery scheduling in the context of a recent PHE may lead to improved postoperative outcomes.

Level iii evidence

Retrospective Cohort Study.

SUBMITTER: Ronan EM

PROVIDER: S-EPMC10498397 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Publications

The Impact of Hospital Exposures Prior to Total Knee Arthroplasty on Postoperative Outcomes.

Ronan Emily M EM Bieganowski Thomas T Christensen Thomas H TH Robin Joseph X JX Schwarzkopf Ran R Rozell Joshua C JC

Arthroplasty today 20230909

<h4>Background</h4>Total knee arthroplasty (TKA) procedures are expected to grow exponentially in the upcoming years, highlighting the importance of identifying preoperative risk factors that predispose patients to poor outcomes. The present study sought to determine if preoperative healthcare events (PHEs) influenced outcomes following TKA.<h4>Methods</h4>This was a retrospective review of all patients who underwent TKA at a single institution from June 2011 to April 2022. Patients who had a PH ...[more]

PMID: 37712072

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Project description:BackgroundPostoperative pain after total knee arthroplasty (TKA) can cause negative emotions, such as anxiety and depression, which can severely affect a patient's long-term quality of life.ObjectiveThis study aimed to investigate the impact of multimodal analgesia (MMA) on postoperative anxiety and depression following total knee arthroplasty.MethodsThis study included 161 patients who underwent TKA from October 2020 to October 2022 in the First Affiliated Hospital of Wannan Medical College, including 79 cases in the control group and 82 cases in the multimodal analgesia group (MMA). The MMA group were administered acetaminophen 0.5 g/d orally 3 days before the surgery, and an ultrasound-guided fascia iliac compartment block (FICB) with 0.25% ropivacaine 30 ml in the inguinal region ipsilateral to the surgery was performed 1 h before surgery. After the surgery, 100 ml solution includes 100 mg ropivacaine, 2.5 mg morphine, and 0.25 mg epinephrine for intra-articular and periarticular injection. Postoperative conventional intravenous analgesia was used in the control group, including 100 mg ropivacaine, 2.5 mg morphine, and 0.25 mg epinephrine for intra-articular and periarticular injection. Patients were scored for pain, anxiety, and depression in the ward at 3 and 7 days postoperatively, and postoperative patients were scored using telephone callbacks at 3 months postoperatively.ResultsIt was found that the visual analog scale (VAS) scores for pain at rest at 3 days, 7 days, and 3 months postoperatively were significantly lower in the MMA group than in the control group (P < 0.05). The scores for pain with movement were significantly lower in the MMA group than in the control group at 3 days and 7 days postoperatively (P < 0.01), but they were similar at 3 months postoperatively. Compared to the control group, the MMA group had significantly higher American Knee Society scores (AKS) at 3 days, 7 days, and 3 months postoperatively (P < 0.05). Compared to the control group, the MMA group had significantly higher Lower Extremity Functional Scale and Hospital Anxiety and Depression Scale scores (HADS) (P < 0.05) at 3 days and 7 days postoperatively; compared to the control group, the MMA group had a significantly shorter hospital stay (P < 0.01).ConclusionMultimodal analgesia can alleviate postoperative anxiety and depression in the short term, reduce perioperative pain, improve postoperative recovery, and shorten the length of hospital stay.

Dataset Information

The Impact of Hospital Exposures Prior to Total Knee Arthroplasty on Postoperative Outcomes.

Background

Methods

Results

Conclusions

Level iii evidence

Publications

The Impact of Hospital Exposures Prior to Total Knee Arthroplasty on Postoperative Outcomes.

Similar Datasets

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