Cardiac interventions on total knee arthroplasty: a national inpatient sample-based analysis

Area of Science:

• Orthopedic surgery outcomes
• Cardiovascular intervention impact
• Patient risk stratification

Background:

• Comorbid cardiovascular diseases are linked to poor total knee arthroplasty (TKA) outcomes.
• Understanding TKA outcomes in patients with prior cardiac interventions is limited.
• This study analyzes TKA outcomes based on specific cardiac treatments.

Purpose of the Study:

• To characterize TKA patients who underwent prior cardiac interventions.
• To compare outcomes among different cardiac intervention groups.
• To identify specific risks and complications associated with TKA post-cardiac procedures.

Main Methods:

• Utilized the 2016-2019 Nationwide Inpatient Sample database.
• Included 558,256 patients undergoing TKA.
• Compared patients with pacemakers (PM), coronary artery bypass (CABG), heart valve surgery (HV), or coronary stents (CS) against those without.

Main Results:

• Cardiac interventions correlated with older age, male gender, longer hospital stays, and higher costs.
• Increased mortality observed in PM, CABG, and CS groups; elevated myocardial infarctions in CABG and CS groups.
• Higher odds of periprosthetic fracture (PM, HV, CS), mechanical complications (HV), deep surgical site infections (CABG, CS), and pneumonia (PM, CABG, CS) were noted.

Conclusions:

• Patients with prior cardiac interventions face elevated risks during TKA hospitalizations.
• Risk factors and complication profiles differ significantly across various cardiac intervention groups.
• Emphasizes the need for personalized medical care and informed patient decision-making for TKA.