Preoperative risk stratification reduces the incidence of perioperative complications after total knee arthroplasty.
The purpose of this study was to validate a screening and management protocol to identify and reduce risk of renal, pulmonary, and delirium complications. A cohort study comparing incidence of perioperative complications on a consecutive series of patients undergoing total knee arthroplasty with a historical control group was conducted. The study cohort was evaluated prospectively to identify and reduce noncardiac medical complications. Medical records were reviewed for in-hospital complications. There were 623 patients in the study cohort and 493 patients in the control population. There was a statistically significant decrease in the incidence of delirium (control, 10.4% vs study, 0.8%; P = .0001), renal (4.9% vs 0.6%, P = .0001), cardiac (16.3% vs 2.1%, P = .0001), and pulmonary complications (5.7% vs 0.8%, P = .0001) in the screened patients vs control. Preoperative screening and management for medical complications resulted in a significant decrease in renal, pulmonary, delirium, and cardiac complications.
Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Kristen E
KE
Radcliff
Fabio R
FR
Orozco
Daniel
D
Quinones
Daniel
D
Rhoades
Gursukhman S
GS
Sidhu
Alvin C
AC
Ong
D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D015331:Cohort Studies; D003693:Delirium / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D008171:Lung Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011446:Prospective Studies; D018570:Risk Assessment