Chinese Medical Sciences Journal ›› 2022, Vol. 37 ›› Issue (4): 303-308.doi: 10.24920/003938
• Original Article • Previous Articles Next Articles
Lulu Ma1, Xuerong Yu1, *(), Xisheng Weng2, Jin Lin2, Jin Jin2, Wenwei Qian2, Yuguang Huang1
Received:
2021-05-21
Accepted:
2022-01-11
Published:
2022-12-31
Online:
2022-12-13
Contact:
Xuerong Yu
E-mail:yxr313@aliyun.com
Lulu Ma, Xuerong Yu, Xisheng Weng, Jin Lin, Jin Jin, Wenwei Qian, Yuguang Huang. Possible Risk Factors for Severe Complications Occurring after Primary Total Knee Arthroplasty[J].Chinese Medical Sciences Journal, 2022, 37(4): 303-308.
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Table 1.
Characteristics of in-hospital postoperative complications after total knee arthroplasty (n = 203)"
Items | Number (%) |
---|---|
Grade | |
Ⅰ | 58 (28.6) |
Ⅱ | 72 (35.5) |
Ⅲ | 63 (31.0) |
Ⅳ | 9 (4.4) |
Ⅴ | 1 (0.5) |
Types | |
Cardiac | 28 (13.7) |
Pulmonary | 14 (6.9) |
Neurologic | 11 (5.4) |
Thromboembolic | 78 (38.2) |
Wound or implant related | 49 (24.0) |
Renal | 15 (7.4) |
Gastrointestinal | 6 (2.9) |
Others | 16 (7.8) |
Table 2.
Comparisons of preoperative parameters between patients who had severe complications and those who did not"
Items | Total (n=2,974) | Severe complication group (n=73) | Non-severe complication group (n=2,901) | χ2 or t value | P value |
---|---|---|---|---|---|
Age (yrs, mean±SD) | 66.5±9.0 | 67.8±8.9 | 66.4±9.0 | 0.670 | 0.210 |
>75 years old [n (%)] | 515 (17.3) | 22 (30.6) | 493 (17.0) | 8.475 | 0.007 |
Sex [n (%)] | 10.922 | 0.002 | |||
Female | 2,403 (80.8) | 48 (65.8) | 2,355 (81.2) | ||
Male | 571 (19.2) | 25 (34.2) | 546 (18.8) | ||
BMI (kg/m2, mean±SD) | 26.8±3.7 | 27.0±4.2 | 26.8±3.7 | 1.877 | 0.657 |
ASA [n (%)] | 4.239 | 0.375 | |||
Ⅰ | 571 (19.2) | 9 (12.3) | 562 (19.4) | ||
Ⅱ | 2,178 (73.2) | 55 (75.3) | 2,123 (73.2) | ||
Ⅲ | 225 (7.6) | 9 (12.3) | 216 (7.4) | ||
NYHA [n (%)] | 3.143 | 0.370 | |||
Ⅰ | 1,333 (44.8) | 26 (35.6) | 1,307 (45.1) | ||
Ⅱ | 1,596 (53.7) | 45 (61.6) | 1,551 (53.5) | ||
Ⅲ | 45 (1.5) | 2 (2.7) | 43 (1.5) | ||
Comorbidity disease [n (%)] | |||||
Hypertension | 1,683 (56.6) | 40 (54.8) | 1,643 (56.6) | 0.098 | 0.811 |
Coronary artery disease | 353 (11.9) | 7 (9.6) | 346 (11.9) | 0.372 | 0.713 |
Arrythmia | 120 (4) | 8 (11.1) | 112 (3.9) | 9.265 | 0.008 |
Cerebrovascular disease | 168 (5.6) | 11 (15.1) | 157 (5.4) | 12.944 | 0.002 |
Chronic kidney disease | 152 (5.1) | 5 (6.8) | 147 (5.1) | 0.466 | 0.421 |
Diabetes mellitus | 556 (18.7) | 15 (20.5) | 541 (18.6) | 0.168 | 0.650 |
COPD | 56 (1.9) | 1 (1.4) | 55 (1.9) | 0.107 | 1.000 |
Smoking [n (%)] | 54 (1.8) | 1 (1.4) | 53 (1.8) | 0.903 | 1.000 |
Diagnosis [n (%)] | 0.134 | 0.645 | |||
Osteoarthritis | 2,762 (92.9) | 67 (91.8) | 2,695 (92.9) | ||
Others | 212 (7.1) | 6 (8.2) | 206 (7.1) |
Table 3.
Comparisons of intra- and postoperative parameters between the patients with and without severe complications"
Items | Total (n=2,974) | Severe complication group (n=73) | Non-severe complication group (n=2,901) | χ2 or t value | P value |
---|---|---|---|---|---|
Type of anesthesia [n (%)] | 0.186 | 0.911 | |||
General anesthesia | 2,812 (94.6) | 69 (94.5) | 2,743 (94.6) | ||
Spinal or spinal combined with epidural | 155 (5.2) | 4 (5.5) | 151 (5.2) | ||
Conversion to general anesthesia | 7 (0.2) | 0 | 7 (0.2) | ||
Type of surgery [n (%)] | 0.013 | 0.901 | |||
Unilateral total knee arthroplasty | 1,974 (66.4) | 48 (65.8) | 1,926 (66.4) | ||
Bilateral total knee arthroplasty | 1,000 (33.6) | 25 (34.2) | 975 (33.6) | ||
Length of anesthesia (min, mean±SD) | 163.1±59.1 | 164.4±57.7 | 163.1±59.1 | 0.002 | 0.840 |
Length of operation (min, mean±SD) | 124.2±55.1 | 125.6±55.6 | 124.1±55.1 | 0.084 | 0.803 |
Length of tourniquet application (min, mean±SD) | 104.1±49.2 | 103.6±52.9 | 104.1±49.1 | 0.664 | 0.912 |
Preoperative hemoglobin (g/L, mean±SD) | 132.4±24.8 | 132.6±12.9 | 132.4±25.0 | 0.001 | 0.928 |
Preoperative anemia [n (%)] | 474 (15.9) | 11 (15.1) | 463 (16.0) | 0.042 | 1.000 |
Perioperative transfusion [n (%)] | 309 (10.4) | 16 (21.9) | 293 (10.1) | 10.682 | 0.003 |
Length of hospital stay [d, median (range)] | 7 (4, 9) | 14 (8.5, 18.5) | 6 (4, 8) | 125.211 | <0.001 |
ICU admission post-operatively [n (%)] | 30 (1.0) | 9 (12.3) | 21 (0.7) | 96.036 | <0.001 |
Table 4.
Binary Logistic regression analysis of predictive risk factors for severe complications after total knee arthroplasty"
Variables | B | Standard error | Wald χ2 | P value | OR | 95%CI |
---|---|---|---|---|---|---|
Male | 0.779 | 0.254 | 9.383 | 0.002 | 2.178 | 1.324-3.585 |
≥75 years old | 0.661 | 0.263 | 6.286 | 0.012 | 1.936 | 1.155-3.244 |
Arrhythmia | 1.069 | 0.392 | 7.430 | 0.006 | 2.913 | 1.350-6.285 |
Cerebrovascular diseases | 1.031 | 0.343 | 9.048 | 0.003 | 2.804 | 1.432-5.489 |
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