The prescreening history and physical in elective total joint arthroplasty.
During 2002 and 2003, 1438 patients underwent a complete medical history and physical by the same hospital-based prescreening program before elective total joint arthroplasty to determine the benefits of this preoperative examination. Sixty percent of patients were female. Mean age was 67.5 years. New diagnoses established as a result of this prescreening program included coronary artery disease (0.12%), congestive heart failure (0.6%), valvular heart disease (3.2%), cardiac dysrhythmia (4.4%), chronic obstructive pulmonary disease (7.2%), cancer (9.6%), hypertension (55.8%), gastrointestinal disorder (37.1%), diabetes mellitus (12.1%), and urinary tract infection (2.2%). Forty-five (2.5%) patients were deemed unacceptable surgical candidates. Patients identified with an increased risk of perioperative cardiac problems were those with a preoperative diagnosis of valvular heart disease (P = .0077), congestive heart failure (P = .0093), or diabetes mellitus (P = .0187).
Meding
John B
JB
Center for Hip and Knee Surgery, St Francis Hospital Mooresville, Mooresville, Indiana 46158, USA.
Klay
Melissa
M
Healy
Angela
A
Ritter
Merrill A
MA
Keating
E Michael
EM
Berend
Michael E
ME
D000368:Aged; D019643:Arthroplasty, Replacement; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking; D018579:Patient Selection; D010808:Physical Examination; D011300:Preoperative Care