title: Assessment of cardiovascular risk in patients undergoing total joint alloplasty: the CRASH-JOINT study.
abstract: BACKGROUND
  Risk assessment is of particular importance for patients undergoing surgical interventions. Orthopaedic procedures, especially total joint alloplasty, are major procedures associated with high perioperative risk, as well as one of the highest rates of complications.
  
  
  OBJECTIVE
  The aim of the present study was to establish the prevalence of classical and non-classical cardiovascular risk factors in patients undergoing total hip or knee alloplasty.
  
  
  METHODS
  The CRASH-JOINT (Cardiovascular Risk Assessment ScHeme in JOINT alloplasty) was a prospective, epidemiological study performed in consecutive patients scheduled for total joint (hip or knee) replacement surgery. Patients enrolled into the study were screened for cardiovascular risk factors and had ambulatory blood pressure performed for the diagnosis of hypertension.
  
  
  RESULTS
  The present study enrolled 98 patients. During initial screening eight patients were disqualified from the study and the surgery, in the majority due to the cardiac causes. Sixty-five patients had a hip joint replacement and 25 had knee joint replacement (mean age 63.7 ± 12.2 years, 62.2% female). Fifty (55.6%) patients were diagnosed with arterial hypertension in the past, ten (11.1%) patients had diabetes mellitus, two (2.2%) had a history of myocardial infarction, and family history of cardiovascular disease was present in 24 (26.7%) cases. Mean body mass index (BMI) was 28.0 ± 5.1 kg/m² and 39 (43.3%) patients were overweight, while 28 (31.1%) were obese. Patients undergoing hip replacement were significantly younger (61.8 ± 12.6 vs. 68.5 ± 10.0 years; p = 0.02), were more often current smokers (24.6% vs. 4.0%; p = 0.03), had significantly lower BMI (26.8 ± 4.5 vs. 31.2 ± 5.3 kg/m²; p < 0.0001), and were less often obese (18.5% vs. 64.0%; p < 0.0001). There were no significant differences between patients scheduled for primary surgery and reoperation.
  
  
  CONCLUSIONS
  The study showed that classical cardiovascular risk factors in patients undergoing total hip or knee alloplasty have a higher prevalent than in the general population, which can potentially contribute to the higher risk of development of perioperative complications.
authors.forename: Paweł
authors.initials: P
authors.lastname: Łęgosz
authors.forename: Marcin
authors.initials: M
authors.lastname: Kotkowski
authors.forename: Anna E
authors.initials: AE
authors.lastname: Platek
authors.forename: Paweł
authors.initials: P
authors.lastname: Małdyk
authors.forename: Bartosz
authors.initials: B
authors.lastname: Krzowski
authors.forename: Anna
authors.initials: A
authors.lastname: Ryś
authors.forename: Karolina
authors.initials: K
authors.lastname: Semczuk
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, Poland. filip.szymanski@wum.edu.pl.
authors.forename: Filip M
authors.initials: FM
authors.lastname: Szymański
authors.forename: Krzysztof J
authors.initials: KJ
authors.lastname: Filipiak
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D011446:Prospective Studies
keywords: cardiovascular risk; hip replacement; knee replacement; orthopaedics