Dialysis Is Not Associated with Increased Risk of Perioperative Complications in TKA Patients after Adjusting for Pertinent Confounders
| Autor: | Chukwuweike U. Gwam, Johannes F. Plate, Samuel Rosas, Chiemena U Ohanale, Rashad Sullivan, Assem A Sultan, Michael E. Seem |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Databases Factual medicine.medical_treatment Knee replacement 03 medical and health sciences 0302 clinical medicine Renal Dialysis Risk Factors Internal medicine medicine Humans Orthopedics and Sports Medicine Arthroplasty Replacement Knee Propensity Score Aged Retrospective Studies 030222 orthopedics business.industry Confounding Retrospective cohort study Regression analysis Confounding Factors Epidemiologic 030229 sport sciences Perioperative Odds ratio Length of Stay Middle Aged Osteoarthritis Knee Arthroplasty Hematocrit Propensity score matching Kidney Failure Chronic Surgery Female business |
| Zdroj: | The journal of knee surgery. 33(8) |
| ISSN: | 1938-2480 |
| Popis: | With a growing prevalence for chronic renal failure, arthroplasty surgeons will find it more likely to have dialysis dependent patients present for knee replacement. Previous retrospective studies using a matched cohort of patients have reported worse perioperative outcomes for dialysis-dependent patients. However, many of these studies failed to control for pertinent confounders. This study aims to fill in that void. The present study compares lengths of stay, discharge status, and 30-day outcomes between dialysis-dependent TKA recipients and a matched cohort of nondialysis dependent TKA recipients. The National Surgical Quality Improvement Program database was used to identify the study cohorts. Patients were propensity score matched based on patient-specific demographic variables, preoperative functional status, and preoperative laboratory values. Generalized regression models were conducted to assess the effects of dialysis dependency on perioperative outcomes. Dialysis dependent patients demonstrated longer mean lengths of stay (+1.14) and a lower likelihood for home discharge (odds ratio [OR] = 0.503). There was no increased risk of 30-day complications in dialysis dependent TKA patients. Our findings demonstrate no increased risk of 30-day complications after TKA when adjusting for pertinent confounders. This suggests TKA is safe for well optimized dialysis dependent patients prior to surgery. |
| Databáze: | OpenAIRE |
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