title: Comparison of perioperative complications in patients with and without rheumatoid arthritis who receive total elbow replacement.
abstract: Total elbow replacement is a well-recognized surgical treatment for patients with advanced rheumatoid arthritis (RA) of the elbow. At present, there is minimal literature outlining the perioperative complications associated with total elbow replacement. We endeavored to identify complication rates and hospital disposition differences between patients with and without RA who received a total elbow replacement. Data from the Nationwide Inpatient Sample was used to capture 3,617 patients who received a total elbow arthroplasty between 1988-2005. Of these, 888 had a primary diagnosis of RA and were compared against patients without RA. Analyses addressed perioperative complications and hospital disposition factors, such as charges and length of stay. Overall complication rates were very low with only 2 variables, respiratory complications (P = .01) and renal failure (P = .04) demonstrating significantly worse outcomes in patients without RA (P = .01). Patients without RA had also had longer lengths of stay (P < 0.01). There were 9 reported perioperative deaths. The findings suggest that the perioperative complications of a total elbow replacement for all patients studied are few and that outcomes in patients with RA are nearly equivalent to those in patients without RA.
authors.affiliation: Center for Excellence in Surgical Outcomes, Duke University, Durham, NC 27708, USA. chad.cook@duke.edu
authors.forename: Chad
authors.initials: C
authors.lastname: Cook
authors.forename: Richard
authors.initials: R
authors.lastname: Hawkins
authors.forename: J Mack
authors.initials: JM
authors.lastname: Aldridge
authors.forename: Stefan
authors.initials: S
authors.lastname: Tolan
authors.forename: Ryan
authors.initials: R
authors.lastname: Krupp
authors.forename: Michael
authors.initials: M
authors.lastname: Bolognesi
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000601:surgery*; D019643:Arthroplasty, Replacement / Q000379:methods*; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology