title: Patient-related risk factors for postoperative mortality and periprosthetic joint infection in medicare patients undergoing TKA.
abstract: BACKGROUND
  The impact of specific baseline comorbid conditions on the relative risk of postoperative mortality and periprosthetic joint infection (PJI) in elderly patients undergoing TKA has not been well defined.
  
  
  OBJECTIVE
  We calculated the relative risk of postoperative mortality and PJI associated with 29 comorbid conditions in Medicare patients undergoing TKA.
  
  
  METHODS
  The Medicare 5% sample was used to calculate the relative risk of 90-day postoperative mortality and PJI as a function of 29 preexisting comorbid conditions in 83,011 patients who underwent primary TKA between 1998 and 2007.
  
  
  RESULTS
  The independent risk factors for 90-day postoperative mortality (in decreasing order of significance) were congestive heart failure, metastatic cancer, renal disease, peripheral vascular disease, cerebrovascular disease, lymphoma, cardiac arrhythmia, dementia, pulmonary circulation disorders, and chronic liver disease. The independent risk factors for PJI (in decreasing order of significance) were congestive heart failure, chronic pulmonary disease, preoperative anemia, diabetes, depression, renal disease, pulmonary circulation disorders, obesity, rheumatologic disease, psychoses, metastatic tumor, peripheral vascular disease, and valvular disease.
  
  
  CONCLUSIONS
  We believe this information important when counseling elderly patients regarding the risks of mortality and PJI after TKA and risk-adjusting publicly reported TKA patient outcomes.
authors.affiliation: UCSF Department of Orthopaedic Surgery and Philip R. Lee Institute for Health Policy Studies, University of California, 500 Parnassus, MU 320W, San Francisco, CA 94143-0728, USA. kevin.bozic@ucsf.edu
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Bozic
authors.forename: Edmund
authors.initials: E
authors.lastname: Lau
authors.forename: Steven
authors.initials: S
authors.lastname: Kurtz
authors.forename: Kevin
authors.initials: K
authors.lastname: Ong
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Berry
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000401:mortality*; D002423:Cause of Death; D016009:Chi-Square Distribution; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000401:mortality*; D016016:Proportional Hazards Models; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D014481:United States