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Early Pulmonary Complications following Total Knee Arthroplasty under General Anesthesia: A Prospective Cohort Study
Kai Song1, Zhen Rong2, Xianfeng Yang2
1Department of Sports Medicine and Adult Reconstruction, Drum Tower Hospital, Medical School of Nanjing University, Zhongshan Road 321, Nanjing, Jiangsu 210008, China; Joint Research Centre for Bone and Joint Disease, Model Animal Research Center (MARC), Nanjing University, Xuefu Road, Nanjing, Jiangsu 210032, China; Centre for Orthopaedic Research, School of Surgery, University of Western Australia, M508, 35 Stirling Highway, Crawley, WA 6009, Australia.
Purpose:
Postoperative pulmonary complications (PPCs) are common after major surgeries. However, the number of studies regarding PPCs following total knee arthroplasty (TKA) is limited. The aim of this study was to determine the incidence of early PPCs following TKA by computed tomography (CT) scan and to identify associated risk factors.
Methods:
Patients, who were diagnosed with osteoarthritis or rheumatoid arthritis and underwent primary TKA at our institution, were included in this prospective cohort study. Patients received a standard procedure of TKA under general anesthesia. Chest CT scan was performed during 5-7 days postoperatively. Univariate analysis and multivariate logistic regression analysis were employed to identify the risk factors.
Results:
The total incidence of early PPCs following TKA was 45.9%. Rates of pneumonia, pleural effusion, and atelectasis were 14.4%, 38.7%, and 12.6%, respectively. Lower body mass index and perioperative blood transfusion were independent risk factors for PPCs as a whole and associated with atelectasis. Postoperative acute episode of hypoxemia increased the risk of pneumonia. Blood transfusion alone was related to pleural effusion.
Conclusions:
The incidence of early PPCs following TKA was high. For patients with relevant risk factors, positive measures should be adopted to prevent PPCs.
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