January 07, 2015
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Significant risk factors may cause cardiac complications following primary TJA

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Significant risk factors for developing postoperative cardiac complications following primary unilateral total joint arthroplasty included being 80 years or older, having a history of cardiac disease and hypertension requiring medication, according to study results.

Using the American College of Surgeons National Surgical Quality Improvement Program data set from 2006 to 2011, researchers identified 46,322 patients who underwent total knee or hip arthroplasty (TKA, THA). Primary outcome measures included cardiac complications occurring within 30 days after surgery.

Philip J. Belmont Jr.

Patients with a new diagnosis or exacerbation of chronic congestive heart failure or a history of angina within 30 days before surgery, a history of myocardial infarction within 6 months, or any percutaneous cardiac intervention or other major cardiac surgery at any time were designated as having a history of cardiac disease. The researchers performed an analysis of the occurrence of all major cardiac complications and deaths within the 30 days postoperative time frame.

Results showed a cardiac complication rate of 0.33% at 30 days postoperatively. The researchers found the three most significant predictors for the development of postoperative cardiac complications in both the total knee and hip arthroplasty groups included an age of 80 years or more, hypertension requiring medication and a history of cardiac disease.

According to the researchers, 79% of patients with a cardiac complication experienced the time of occurrence within 7 days after surgery.

Disclosure: Belmont received payment from Slack Incorporated. Please see the full study for a list of all other authors’ relevant financial disclosures.