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Risk Factors Associated With Postoperative Cardiac Events Following Total Hip and Knee Arthroplasty

Shivan N Chokshi1, Vanessa Liu1, William M Weiss2

  • 1John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, Texas.

The Journal of Arthroplasty
|September 27, 2023
PubMed

Insights

Patients undergoing total joint arthroplasty face increased cardiac risks. Pre-existing conditions like prior myocardial infarction and renal insufficiency significantly elevate the likelihood of adverse cardiac events post-surgery.

Area of Science:

  • Orthopedic Surgery
  • Cardiology
  • Public Health

Background:

  • Adverse cardiac events are a concern following total joint arthroplasty.
  • Investigating cardiac risk factors is crucial for patient outcomes.

Purpose of the Study:

  • To determine the prevalence of adverse cardiac events after total hip arthroplasty (THA) and total knee arthroplasty (TKA).
  • To analyze specific risk factors associated with perioperative cardiac complications.

Main Methods:

  • Utilized a large national database for data extraction.
  • Analyzed 80,544 THA and 112,531 TKA patients.
  • Performed chi-squared and multivariate analyses on cardiac risk factors including diabetes, renal insufficiency, prior MI, hypertension, and cerebrovascular disease.

Main Results:

  • 34% of THA and 52% of TKA patients had at least one cardiac risk factor.
  • At-risk patients showed significantly higher odds of troponin elevation, myocardial infarction (MI), and heart failure within 30 days.
  • Prior MI was the strongest predictor for troponin elevation and MI; renal insufficiency for heart failure.

Conclusions:

  • Risk stratification is essential for minimizing adverse outcomes in orthopedic surgery.
  • Identifying and considering patient risk factors before joint arthroplasty is critical.
Abstract

Keywords:
cardiac complicationsorthopedicsoutcomestotal hip arthroplastytotal knee arthroplasty

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