scholarly journals Subjective Cognitive Decline May Be Associated With Post-operative Delirium in Patients Undergoing Total Hip Replacement: The PNDABLE Study

2021 ◽  
Vol 13 ◽  
Author(s):  
Xu Lin ◽  
Fanghao Liu ◽  
Bin Wang ◽  
Rui Dong ◽  
Lixin Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Trial ◽  
Cognitive Decline ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Protective Factor ◽  
Subjective Cognitive Decline ◽  
Total Hip ◽  
Increased Risk ◽  
T Tau

Objective: Subjective cognitive decline (SCD) is associated with an increased risk of clinical cognitive disorders. Post-operative delirium (POD) is a common complication after total hip replacement. We aimed to investigate the relationship between SCD and POD in patients undergoing total hip replacement.Methods: Our study recruited 214 cognitively intact individuals from the Perioperative Neurocognitive Disorder And Biomarker Lifestyle (PNDABLE) study in the final analysis. SCD was diagnosed with Subjective Cognitive Decline Scale (SCDS), Mini-Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA). The incidence of POD was evaluated by using Confusion Assessment Method (CAM), and POD severity was measured by using the Memorial Delirium Assessment Scale (MDAS). Preoperative cerebrospinal fluid (CSF) Aβ40, Aβ42, T-tau, and P-tau levels were measured by enzyme-linked immune-sorbent assay (ELISA).Results: Overall, the incidence of POD was 26.64% (57/214), including 32.43% (36/111) in the SCD group and 20.39% (21/103) in the NC group. With the increase of age, the incidence of POD in all age groups increased (P < 0.05). Logistic regression analysis showed that after adjusting for SCD, Aβ42, Aβ40, P-tau, and T-tau, SCD (OR 2.32, CI 1.18–4.55, P = 0.01) and the increased CSF level of P-tau (OR 1.04, CI 1.01–1.06, P < 0.001) were risk factors for POD, while the level of aβ42 (OR 0.99, CI 0.99–1.00, P < 0.001) was a protective factor for POD.Conclusion: SCD is one of the preoperative risk factors for POD.Clinical Trial Registration: This study was registered at China Clinical Trial Registry (Chictr200033439).

Total Hip Replacement Provokes Endothelial Dysfunction

Angiology ◽  
2018 ◽  
Vol 69 (10) ◽  
pp. 871-877 ◽  
Author(s):  
Peter Poredos ◽  
Ana Mavric ◽  
Lara Leben ◽  
Pavel Poredos ◽  
Mateja Kaja Jezovnik
Keyword(s):  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Total Hip Replacement ◽  
Postoperative Period ◽  
Hip Replacement ◽  
Hospital Length Of Stay ◽  
Average Hospital ◽  
Total Hip ◽  
Increased Risk ◽  
Cardiovascular Homeostasis

Surgery represents an increased risk of different perioperative complications. Endothelial function (EF) is a key mechanism responsible for cardiovascular homeostasis and is involved in thromboembolic complications. We aimed to follow changes of EF in an early postoperative period in patients undergoing total hip replacement (THR). Endothelial function was assessed noninvasively in 70 consecutive patients who underwent an elective THR under spinal anesthesia. Flow-mediated dilation (FMD) and low flow-mediated constriction capability of the brachial artery, which are indicators of EF were measured before the operation (baseline), 24 hours after the operative procedure, and 5 to 7 days postoperatively. Baseline FMD was 12.3% and decreased a day after surgery to 7.3% ( P < .001). After 5 to 7 days, it gradually increased to 9.2%. However, on average, it was lower than before surgery ( P < .001). The median duration of THR was 85.0 (65.0-100.0) minutes, the average hospital length of stay was 7 days. Total hip replacement is associated with an immediate decrease in FMD which remains significantly decreased 5 to 7 days after the surgery compared with the preoperative value. These results indicate that surgery provokes endothelial dysfunction and deteriorates cardiovascular homeostasis. This effect could be involved in cardiovascular complications in the postoperative period.

Evaluation of risk factors for luxation after total hip replacement in dogs

2000 ◽  
Vol 29 (6) ◽  
pp. 524-532 ◽  
Author(s):  
Jonathan Dyce ◽  
Erik R. Wisner ◽  
Qiang Wang ◽  
Marvin L. Olmstead
Keyword(s):  
Risk Factors ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Total Hip

Serious Symptomatic Thromboembolic Complications in Patients Undergoing Total Hip Replacement - A Prospective Study.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 630-630
Author(s):  
Camilla Ryge ◽  
Michael Rud Lassen ◽  
Soeren Solgaard ◽  
Stig Sonne-Holm
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Total Hip Replacement ◽  
Logistic Regression Analysis ◽  
Hip Replacement ◽  
Significant Risk ◽  
Vascular Events ◽  
Total Hip ◽  
Vein Thrombosis

Abstract Purpose: To describe the rate and time of onset of serious thromboembolic (TE) complications within the first 90 postoperative days in an unselected population of THR patients. Secondary to analyse the data base for possible risk factors of TE. Material and method: Five hundred (430 primary THR and 70 revision THR) consecutive patients undergoing THR in Frederiksborg County, Denmark from January 2004 until May 2005 participated. The patients were interviewed the day before surgery for medical history. On the 5th postoperative day and at a telephone interview 90 days postoperatively patients were asked about signs and symptoms of acute myocardial infarction (AMI), pulmonary embolism (PE), deep vein thrombosis (DVT), transitory cerebral ischemia (TCI)/stroke, retinal vein thrombosis (RVT) and other cardio vascular events. All events were validated in hospital and/or the general practitioners files, using international criteria. All patients except 1 had chemical thromboprophylaxis during hospitalization. No patients had extended thromboprophylaxis after discharge. 498 patients had 90 days follow-up. Two patients withdrew their consent. Results: 24 patients (4.8%) experienced at least one serious TE complication during the first 90 days after the operation. Two (0.4%) patients died in relation to the operation (no autopsy was performed). Five patients (1.0%) had PE. One patient (0.2%) had AMI, 10 (2.0%) had DVT, two (0.4%) had RVT and four (0.8%) had TCI. Two patients experienced two events - one had AMI and later on a TCI, another had PE and TCI on the same day. Nine patients had their first event during the first five postoperative days - 15 patients had their first event after the 5th postoperative day. The only significant risk factor found in a backward logistic regression analysis including interaction (test for confounder/bias) was the length of the operation P=0.003 OR= 1.016 (1.005–1.026). This study has not been able to show any significant correlation between age, gender, co-morbidities, preoperative hemoglobin value ore platelet count, high ASA-score, kind of anesthesia, indication for operation or use of cement or interactions between the above in the logistic regression analysis, but individually all these factors were significant risk factors in the introductory bivariate analysis. Discussion: This study shows that venous and arterial thrombotic complications persist to be a major contribution to postoperative morbidity and mortality after elective total hip replacement, despite of rigorous early mobilization and optimized regimens of prevention of thromboembolism. After this study has been performed ACCP has recommended extend prophylaxis by LMWH, pentasaccharide or warfarin up to 4–5 weeks after total hip replacement. Further research to identify patients at risk is warranted to optimize risk/benefit of total hip replacement and prevention of venous and arterial thromboembolism. The majority of events occurred after discharge calling for improvement of the post-discharge period to reduce the risk of serious thromboembolism.

Total hip replacement due to osteoarthritis: the importance of age, obesity, and other modifiable risk factors

2003 ◽  
Vol 114 (2) ◽  
pp. 93-98 ◽  
Author(s):  
Elizabeth W Karlson ◽  
Lisa A Mandl ◽  
Gideon N Aweh ◽  
Oliver Sangha ◽  
Matthew H Liang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Modifiable Risk Factors ◽  
Total Hip

scholarly journals Profiles of Biomarkers of Excess Alcohol Consumption in Patients Undergoing Total Hip Replacement: Correlation with Function

2011 ◽  
Vol 11 ◽  
pp. 1804-1811 ◽  
Author(s):  
Paul J. Jenkins ◽  
Andrew D. Duckworth ◽  
Francis P. C. Robertson ◽  
Colin R. Howie ◽  
James S. Huntley
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Alcohol Misuse ◽  
Future Research ◽  
Total Hip ◽  
Increased Risk ◽  
Functional Scores ◽  
Hip Function ◽  
One Year ◽  
General Physical

Aims. Patients who misuse alcohol may be at increased risk of surgical complications and poorer function following hip replacement. Identification and intervention may lead to harm reduction and improve the outcomes of surgery. The aim of this study was to determine the prevalence of biomarker elevation in patients undergoing hip replacement and to investigate any correlation with functional scores and complications.Methods. We performed a retrospective study that examined the profile of biomarkers of alcohol misuse in 1049 patients undergoing hip replacement.Results. Gamma-glutamyltransferase was elevated in 150 (17.6%), and mean corpuscular volume was elevated in 23 (4%). At one year general physical health was poorer where there was elevation ofγGT, and the mental health and hip function was poorer with elevation of MCV. There were no differences in complications.Discussion. Raised biomarkers can alert clinicians to potential problems. They also provide an opportunity to perform further investigation and offer intervention. Future research should focus on the use in orthopaedic practice of validated screening questionnaires and more sensitive biomarkers of alcohol misuse.Conclusion. This study demonstrates a potential substantial proportion of unrecognised alcohol misuse that is associated with poorer functional scores in patients after total hip replacement.

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