Influence of preoperative cardiovascular risk factor clusters on complications of total joint arthroplasty.

Christopher J. Dy, James D. Wilkinson, Leonardo Tamariz, Sean P. Scully

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Identification of preexisting cardiovascular risk factors is important in projecting postoperative outcomes. Using claims data for 16,317 patients who underwent total hip arthroplasty and/or total knee arthroplasty, we performed logistic regression and survival analysis to determine the effects of hypertension, diabetes, dyslipidemia,and obesity (both independently and in clusters) on incidence of myocardial infarction (MI), venous thromboembolism (VTE), and revision arthroplasty. Our results indicated that diabetes (odds ratio [OR],1.55; P<.05) and hypertension (OR, 1.56; P<.05) were independent risk factors for postoperative MI. Risk for MI increased significantly with the addition of each risk factor; there was a 128% increase in risk when all 4 cardiovascular risk factors were present (OR, 2.28; P<.0001). Risk for VTE did not change significantly with 1, 2, or 3 risk factors but reached statistical significance when all 4 risk factors were present (hazard ratio, 3.20; P = .05). There was no association between cardiovascular risk factors and incidence of revision arthroplasty. Our analysis confirmed that diabetes and hypertension are risk factors for postoperative MI, but the respective significant and near significant increased risks for MI and VTE seen with cardiovascular risk factor clustering merit further evaluation of the role of metabolic syndrome in patients who undergo arthroplasty.

Original languageEnglish
Pages (from-to)560-565
Number of pages6
JournalAmerican journal of orthopedics (Belle Mead, N.J.)
Volume40
Issue number11
StatePublished - Nov 1 2011
Externally publishedYes

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Arthroplasty
Joints
Myocardial Infarction
Venous Thromboembolism
Odds Ratio
Hypertension
Knee Replacement Arthroplasties
Incidence
Survival Analysis
Dyslipidemias
Cluster Analysis
Hip
Obesity
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Influence of preoperative cardiovascular risk factor clusters on complications of total joint arthroplasty. / Dy, Christopher J.; Wilkinson, James D.; Tamariz, Leonardo; Scully, Sean P.

In: American journal of orthopedics (Belle Mead, N.J.), Vol. 40, No. 11, 01.11.2011, p. 560-565.

Research output: Contribution to journalArticle

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