[Clinical characteristics of patients undergoing major orthopaedic surgery in a real-world clinical practice: a...

To evaluate the prevalence of risk factors in patients undergoing large joint arthroplasty in real-world practice.

Medical history, information about concomitant diseases and previously prescribed drug therapy was recorded in all participants. In addition, essential laboratory and instrumental examination was performed.

The study population included 617 (35.6%) males and 1116 (64.4%) females. The mean age was 64.7±10.4 years, and in 90.5% of patients the mean body mass index exceeded 25 kg/m². The majority (77.6%) of patients had hypertension and other cardiovascular diseases. Glycemic disorders had 371 (21.4%) patients, with glycemic control being inadequate in 14 (3,8%) of these patients. Chronic kidney disease stages II-V was found in 1,330 (76.7%) patients and all of them also had obesity and hypertension. At study entry, 262 (15.1%) patients were taking different anticoagulants, and 534 (30.9%) patients were taking antiplatelet agents.

The primary patient population undergoing large-joint arthroplasty of the lower extremities consists of elderly individuals with a high burden of comorbidities (obesity, hypertension, chronic kidney disease, and diabetes), which increases the risk of perioperative complications. The published literature contains limited information regarding the necessary scope of preoperative assessment in these patient subpopulations with various concomitant diseases, as well as potential adjustments to postoperative management strategies. It may be necessary to conduct large-scale prospective studies specifically focusing on various patient cohorts, accompanied by pharmacoeconomic analyses, to determine the necessity and scope of expanded diagnostic workups in this population at high risk for perioperative complications.