scholarly journals Risk Factors for Transfusions Following Total Joint Arthroplasty in Patients With Rheumatoid Arthritis

2018 ◽  
Vol 24 (8) ◽  
pp. 422-426 ◽  
Author(s):  
Elizabeth Salt ◽  
Amanda T. Wiggins ◽  
Mary Kay Rayens ◽  
Katelyn Brown ◽  
Kate Eckmann ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty

scholarly journals Risk Factors for Infection Following Total Joint Arthroplasty in Rheumatoid Arthritis

2013 ◽  
Vol 7 (1) ◽  
pp. 119-124 ◽  
Author(s):  
Ranjani Somayaji ◽  
Cheryl Barnabe ◽  
Liam Martin
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Hospital Admission ◽  
Total Joint Arthroplasty ◽  
Surgical Site Infections ◽  
Joint Arthroplasty ◽  
Increased Risk ◽  
Artery Disease

Objectives: Determine risk factors for infection following hip or knee total joint arthroplasty in patients with rheumatoid arthritis. Methods: All rheumatoid arthritis patients with a hip or knee arthroplasty between years 2000 and 2010 were identified from population-based administrative data from the Calgary Zone of Alberta Health Services. Clinical data from patient charts during the hospital admission and during a one year follow-up period were extracted to identify incident infections. Results: We identified 381 eligible procedures performed in 259 patients (72.2% female, mean age 63.3 years, mean body mass index 27.6 kg/m2). Patient comorbidities were hypertension (43.2%), diabetes (10.4%), coronary artery disease (13.9%), smoking (10.8%) and obesity (32%). Few infectious complications occurred: surgical site infections occurred within the first year after 5 procedures (2 joint space infections, 3 deep incisional infections). Infections of non-surgical sites (urinary tract, skin or respiratory, n=4) complicated the hospital admission. The odds ratio for any post-arthroplasty infection was increased in patients using prednisone doses exceeding 15 mg/day (OR 21.0, 95%CI 3.5-127.2, p=<0.001), underweight patients (OR 6.0, 95%CI 1.2-30.9, p=0.033) and those with known coronary artery disease (OR 5.1, 95%CI 1.3-19.8, p=0.017). Types of disease-modifying therapy, age, sex, and other comorbidities were not associated with an increased risk for infection. Conclusion: Steroid doses over 15 mg/day, being underweight and having coronary artery disease were associated with significant increases in the risk of post-arthroplasty infection in rheumatoid arthritis. Maximal tapering of prednisone and comorbidity risk reduction must be addressed in the peri-operative management strategy.

Incidence of and Risk Factors for 30-Day Readmission Following Elective Primary Total Joint Arthroplasty: Analysis From the ACS-NSQIP

2013 ◽  
Vol 28 (9) ◽  
pp. 1499-1504 ◽  
Author(s):  
Andrew J. Pugely ◽  
John J. Callaghan ◽  
Christopher T. Martin ◽  
Peter Cram ◽  
Yubo Gao
Keyword(s):  
Risk Factors ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Acs Nsqip

The Incidence And Risk Factors of Serum Hypokalemia After Primary Total Joint Arthroplasty

2021 ◽  
Author(s):  
Pin Pan ◽  
Zitao Zhang ◽  
Xiaofeng Zhang ◽  
Qing Jiang ◽  
Zhihong Xu
Keyword(s):  
Risk Factors ◽  
Red Blood Cells ◽  
Knee Replacement ◽  
Serum Potassium ◽  
Total Joint Arthroplasty ◽  
Blood Cells ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
Joint Arthroplasty ◽  
Regular Monitoring

Abstract Background: Regular monitoring of serum potassium after total joint arthroplasty (TJA) is a routine examination, which can detect abnormal serum potassium and reduce adverse events timely caused by postoperative hypokalemia. In this study, we aimed to investigate the incidence and risk factors of hypokalemia after primary total hip and knee replacement.Methods: This study included patients who underwent unilateral total knee or hip arthroplasty in our department from April 2017 to March 2018. The serum potassium level before and after operation was collected and retrospectively analyzed. The differences in age, BMI and other factors between hypokalemia patients and non-hypokalemia patients at different time points after surgery were compared, and then the risk factors of postoperative hypokalemia were analyzed based on multiple logistic regression.Results: The total incidence of postoperative hypokalemia was 53.1%, while the respective rate on the first, third and fifth postoperative day was 12.5%, 40.7% and 9.6%. The serum potassium level on the first, third and fifth postoperative day was 3.84±0.32mmol/l, 3.59±0.34mmol/l and 3.80±0.32mmol/l, while among which, the level on the third day was the lowest (p=0.015). The independent risk factors for hypokalemia after total hip and knee replacement were the level of preoperative serum potassium (p=0.011), preoperative red blood cells (p=0.027), and a history of diabetes (p=0.007).Conclusion: Regular monitoring of serum potassium should be performed after TJA due to hypokalemia was a very common complication. We need to pay more attention to patients’ preoperative potassium and red blood cells, especially patients with diabetes.

scholarly journals Risk Factors for Surgical Site Infection Following Total Joint Arthroplasty

2014 ◽  
Vol 96 (18) ◽  
pp. e158-1-5 ◽  
Author(s):  
Mohammad R Rasouli ◽  
Camilo Restrepo ◽  
Mitchell G Maltenfort ◽  
James J Purtill ◽  
Javad Parvizi
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Site Infection

The Most Significant Risk Factors for Urinary Retention in Fast-track Total Joint Arthroplasty are Iatrogenic

2019 ◽  
Vol 34 (1) ◽  
pp. 136-139 ◽  
Author(s):  
Mohamad J. Halawi ◽  
Nicholas Caminiti ◽  
Mark P. Cote ◽  
Adam D. Lindsay ◽  
Vincent J. Williams
Keyword(s):  
Risk Factors ◽  
Urinary Retention ◽  
Total Joint Arthroplasty ◽  
Fast Track ◽  
Significant Risk ◽  
Joint Arthroplasty

Should postoperative haemoglobin and potassium levels be checked routinely following blood-conserving primary total joint arthroplasty?

2019 ◽  
Vol 101-B (1_Supple_A) ◽  
pp. 25-31 ◽  
Author(s):  
N. J. Greco ◽  
A. G. Manocchio ◽  
A. V. Lombardi ◽  
S. L. Gao ◽  
J. Adams ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Total Joint Arthroplasty ◽  
Laboratory Data ◽  
Joint Arthroplasty ◽  
Renal Diseases ◽  
Study Cohort ◽  
Blood Conservation ◽  
Potassium Supplementation ◽  
History Of

Aims Despite declining frequency of blood transfusion and electrolyte supplementation following total joint arthroplasty, postoperative blood analyses are still routinely ordered for these patients. This study aimed to determine the rate of blood transfusion and electrolyte restoration in arthroplasty patients treated with a perioperative blood conservation protocol and to identify risk factors that would predict the need for transfusion and electrolyte supplementation. Patients and Methods Patients undergoing primary total joint arthroplasty of the hip or knee between July 2016 and February 2017 at a single institution were included in the study. Standard preoperative and postoperative laboratory data were collected and reviewed retrospectively. A uniform blood conservation programme was implemented for all patients. Need for blood transfusion or potassium supplementation was determined through a coordinated decision by the care team. Rates of transfusion and supplementation were observed, and patient risk factors were noted. Results The overall rate of blood transfusion was 1.06% in the study population of 1132 total joint arthroplasties performed in 1023 patients. Of the 12 patients requiring transfusion, 11 were female, ten occurred in patients undergoing total hip arthroplasty, and all 12 patients had a preoperative haemoglobin level less than 130 g/l. Operative duration and surgical blood loss were significantly greater in those patients requiring blood transfusion. Nearly all patients requiring transfusion had a history of, or risk factors for, cardiovascular disease. Potassium supplementation was required in 15.5% of the study cohort; 72% of these patients receiving potassium presented with a potassium level less than 4 mmol/l during preoperative testing, while the remaining 28% had a past medical history of either significant anaemia, cardiopulmonary, cardiovascular, or renal diseases that had required substantial medical management. Conclusion A consistent blood-conserving perioperative strategy effectively minimized need for blood transfusion in total joint arthroplasty patients below previously reported rates in the literature. We suggest that postoperative full blood counts and basic metabolic panels should not routinely be ordered in these patients unless their preoperative haemoglobin and potassium is below 130 g/dl or 4 mmol/l respectively, and they have medical comorbidities.

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