The influence of elevated international normalized ratio on complications following total shoulder arthroplasty.

Autor:	Wang KY; Department of Orthopaedic Surgery, Johns Hopkins, Columbia, MD, USA., Quan T; Department of Orthopaedic Surgery, George Washington Hospital, Washington, DC, USA., Kapoor S; Department of Orthopaedic Surgery, Johns Hopkins, Columbia, MD, USA., Gu A; Department of Orthopaedic Surgery, George Washington Hospital, Washington, DC, USA., Best MJ; Department of Orthopaedic Surgery, Johns Hopkins, Columbia, MD, USA., Kreulen RT; Department of Orthopaedic Surgery, Johns Hopkins, Columbia, MD, USA., Srikumaran U; Department of Orthopaedic Surgery, Johns Hopkins, Columbia, MD, USA.
Jazyk:	angličtina
Zdroj:	Shoulder & elbow [Shoulder Elbow] 2023 Sep; Vol. 15 (1 Suppl), pp. 53-64. Date of Electronic Publication: 2022 Mar 21.
DOI:	10.1177/17585732221088974
Abstrakt:	Background: Identifying preoperative risk factors for complications following total shoulder arthroplasty (TSA) has both clinical and financial implications. The purpose of this study was to determine the influence of different degrees of preoperative INR elevation on complications following TSA. Methods: Patients undergoing primary TSA from 2007 to 2018 were identified in a national database. Patients were stratified into 4 cohorts: INR of <1.0, INR of >1.0 to 1.25, INR of >1.25 to 1.5, and INR of >1.5. Postoperative complications were assessed. Multivariate logistic regressions were performed to adjust for differences in demographics and comorbidities among the INR groups. Results: Following adjustment and relative to patients with an INR of <1.0, those with INR of >1.0-1.25, >1.25-1.5, and >1.5 had 1.6-times, 2.4-times, and 2.8-times higher odds of having postoperative bleeding requiring transfusion, respectively (p < 0.05 for all). Relative to patients with INR <1.0, those with INR of > 1.25-1.5 and INR of >1.5 had 7.8-times and 7.0-times higher odds of having pulmonary complications, respectively (p < 0.05 for both). Discussion: With increasing INR levels, there is an independent and step-wise increase in odd ratios for postoperative complications. Current guidelines for preoperative INR thresholds may need to be adjusted for more predictive risk-stratification for TSA. Level of Evidence: III. Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. (© The Author(s) 2022.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu