scholarly journals Early Pulmonary Complications following Total Knee Arthroplasty under General Anesthesia: A Prospective Cohort Study Using CT Scan

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Kai Song ◽  
Zhen Rong ◽  
Xianfeng Yang ◽  
Yao Yao ◽  
Yeshuai Shen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Cohort Study ◽  
Pleural Effusion ◽  
Blood Transfusion ◽  
Ct Scan ◽  
Knee Arthroplasty ◽  
Prospective Cohort ◽  
Pulmonary Complications ◽  
Total Knee

Purpose.Postoperative pulmonary complications (PPCs) are common after major surgeries. However, the number of studies regarding PPCs following total knee arthroplasty (TKA) is limited. The aim of this study was to determine the incidence of early PPCs following TKA by computed tomography (CT) scan and to identify associated risk factors.Methods.Patients, who were diagnosed with osteoarthritis or rheumatoid arthritis and underwent primary TKA at our institution, were included in this prospective cohort study. Patients received a standard procedure of TKA under general anesthesia. Chest CT scan was performed during 5–7 days postoperatively. Univariate analysis and multivariate logistic regression analysis were employed to identify the risk factors.Results.The total incidence of early PPCs following TKA was 45.9%. Rates of pneumonia, pleural effusion, and atelectasis were 14.4%, 38.7%, and 12.6%, respectively. Lower body mass index and perioperative blood transfusion were independent risk factors for PPCs as a whole and associated with atelectasis. Postoperative acute episode of hypoxemia increased the risk of pneumonia. Blood transfusion alone was related to pleural effusion.Conclusions.The incidence of early PPCs following TKA was high. For patients with relevant risk factors, positive measures should be adopted to prevent PPCs.

scholarly journals The Risk Factors and Predictive Nomogram for Length Of Stay More than 14 Days in Undergoing TKA Patients: A Secondary Analysis Based on a Cohort Study in Singapore

2021 ◽  
Author(s):  
Bo Liu ◽  
Yijiang Ma ◽  
Chunxiao Zhou ◽  
zhijie wang
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Cohort Study ◽  
Blood Transfusion ◽  
Length Of Stay ◽  
Knee Arthroplasty ◽  
Secondary Analysis ◽  
Lasso Regression ◽  
Total Knee ◽  
Operation Duration

Abstract Objective: The aim was to explore the risk factors and establish a predictive nomogram of length of stay (LOS) more than 14 days in a undergoing Total knee arthroplasty (TKA) cohort .Methods: We used the raw data, a retrospective cohort study of 2622 patients undergoing TKA in Singapore, for secondary analysis. The LASSO regression was used to optimize feature selection for the LOS more than 14 days. The Multivariable logistic regression analysis was applied to build a predicting nomogram by using the feature selected in the LASSO regression model. In order to evaluate the prediction ability of the model, we calculated the C-index. Simultaneously, the ROC curve, the Calibration curve and the DCA curve was draw to assess the model. Finally, we used 1000 times bootstrap method to verify the accuracy of the model. Results: Finally, 100(3.81%) patients were hospitalized for more than 14 days and 2522 patients (96.19%) were less 14 days. Patient age, ASA status, type of anesthesia, operation duration, procedure description, DM, IHD, CHF, day of operation and blood transfusion were determined and incorporated into the diagnostic nomogram. The C-index was 0.797(95% CI: 0.755-0.839).The calibration curve showed that the model had good recognition ability.The DCA curve analysis showed that the risk nomogram of length of stay more than 14 days was clinically useful.The C-index is 0.763 through 1000 times bootstrapping validation.Conclusion:We used the age, ASA status, type of anesthesia, operation duration, procedure description, DM, IHD, CHF, day of operation and blood transfusion to establish the clinical prediction model , this method can conveniently predict the risk of individual patients with total knee arthroplasty length of stay for more than 14 days.

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