title: Effects of Systemic Disorders on Postoperative Complications After Simultaneous Bilateral Total Knee Replacement.
abstract: OBJECTIVE
  The aim of the present study was to retrospectively evaluate the association between accompanying systemic disorders and major complications developing in the early postoperative period in patients who underwent simultaneous bilateral total knee arthroplasty with combined spinal and epidural anaesthesia.
  
  
  METHODS
  In the present study, the medical records of a total of 456 patients were analyzed. Preoperative data, including the American Society of Anesthesiologists physical status and presence of coronary artery disease (CAD), chronic pulmonary disease, diabetes mellitus (DM), hypertension and renal insufficiency were recorded. Furthermore, the data related to major complications, such as cardiac complications, respiratory complications, acute myocardial infarction (AMI), thromboembolism, cerebrovascular accident (CVA), confusion, acute renal failure (ARF), shock and cardiopulmonary arrest were recorded.
  
  
  RESULTS
  We found that the frequency of complications markedly increased in the presence of concurrent DM and hypertension, or DM, hypertension and CAD, or DM and CAD. Further, 0.2% of the patients developed AMI, 3.3% developed cardiac complications, 2.2% developed respiratory complications, 0.9% developed thromboembolism, 0.2% developed CVA, 2% developed confusion and 0.4% developed cardiac arrest and shock in the first week after the operation. The frequency of cardiac and pulmonary complications and confusion was higher in patients aged above 65 years compared to patients below 65 years.
  
  
  CONCLUSIONS
  We observed that the frequency of cardiac and pulmonary complications and confusion in the early postoperative period was markedly higher in patients aged above 65 years and in patients with concurrent DM and cardiovascular comorbidities.
authors.affiliation: Department of Anaesthesia, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Tünay
authors.initials: T
authors.lastname: Kandemir
authors.affiliation: Department of Anaesthesia, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Selda
authors.initials: S
authors.lastname: Muslu
authors.affiliation: Department of Anaesthesia, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Kalaycı
authors.affiliation: Department of Anaesthesia, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Erbin
authors.initials: E
authors.lastname: Kandemir
keywords: Knee replacement; comorbidity; postoperative complications; regional anaesthesia