Older patients and patients with diabetes have an increased risk of mortality and postoperative complications following primary total unilateral knee arthroplasty, according to recently published data.
Philip J. Belmont, Jr., MD and colleagues studied 15,321 patients who underwent primary unilateral total knee arthroplasty (TKA). They found that the results “underscore that diabetes mellitus and increased age are notable risk factors for mortality.”
The patients in the study had a mean age of 67.3 years. Overall, 61.2% of the patients were classified as having obesity, 18.2% of the patients had diabetes, and 50% of the patients were graded as class 3 or higher on the basis of the American Society of Anesthesiologists (ASA) classification system.
The researchers found a 30-day mortality rate of 0.18%. Overall, 1.83% of the patients had major complications and 5.6% of the patients experienced overall complications. Cardiac arrest (44%), systemic shock (18.5%) and renal failure (18.5%) were the most common specific complications among the patients who died. Risk factors for complications after TKA were an age of 80 years or older, operative times greater than 135 minutes, body mass indices of 40 kg/m2 or greater, and ASA classification of 3 or greater.
“The 2.2% mortality or major complication rate that we found for patients who underwent a unilateral TKA confirms the need for diligent medical management during the perioperative period,” Belmont stated in the study.
Belmont P. J Bone Joint Surg Am. 2014;doi: 10.2106/JBJS.M.00018.
Disclosure: One or more of the authors received payments or services, either directly or indirectly, from a third party in support of an aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship with an entity in the biomedical arena that could be perceived to have the potential to influence this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to have the potential to influence this work.