Abnormally High, as Well as Low, Preoperative Platelet Counts Correlate With Adverse Outcomes and Readmissions After Elective Total Knee Arthroplasty

Malpani, Rohil; Haynes, Monique S.; Clark, Michael G.; Galivanche, Anoop R.; Bovonratwet, Patawut; Grauer, Jonathan N.

doi:10.1016/j.arth.2019.04.012

Cited by 26 publications

(23 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Studies of THA and TKA indicate that both abnormally high and abnormally low preoperative platelet counts are associated with higher rates of complications for both types of surgery. 24 , 25 …”

mentioning

confidence: 99%

Abnormal preoperative platelet count may predict postoperative complications following shoulder arthroplasty

Kim¹,

Ling²,

Nazemi³

et al. 2022

JSES International

View full text Add to dashboard Cite

mentioning

confidence: 99%

Abnormal preoperative platelet count may predict postoperative complications following shoulder arthroplasty

Kim¹,

Ling²,

Nazemi³

et al. 2022

JSES International

View full text Add to dashboard Cite

“…The ACS-NSQIP database records ten commonly ordered preoperative blood markers, of which six were selected a priori given their use in practice and potential association with arthroplasty outcomes and included in our analysis as covariates of interest: albumin, 7 haematocrit, 31 platelets, 32 sodium, 33 and white blood cells (WBCs). 34 Estimated globular filtration rate was derived using creatinine, age, sex, and race.…”

Section: Methodsmentioning

confidence: 99%

The association of preoperative blood markers with postoperative readmissions following arthroplasty

et al. 2021

View full text Add to dashboard Cite

Aims While preoperative bloodwork is routinely ordered, its value in determining which patients are at risk of postoperative readmission following total knee arthroplasty (TKA) and total hip arthroplasty (THA) is unclear. The objective of this study was to determine which routinely ordered preoperative blood markers have the strongest association with acute hospital readmission for patients undergoing elective TKA and THA. Methods Two population-based retrospective cohorts were assembled for all adult primary elective TKA (n = 137,969) and THA (n = 78,532) patients between 2011 to 2018 across 678 North American hospitals using the American College of Surgeons National Quality Improvement Programme (ACS-NSQIP) registry. Six routinely ordered preoperative blood markers - albumin, haematocrit, platelet count, white blood cell count (WBC), estimated glomerular filtration rate (eGFR), and sodium level - were queried. The association between preoperative blood marker values and all-cause readmission within 30 days of surgery was compared using univariable analysis and multivariable logistic regression adjusted for relevant patient and treatment factors. Results The mean TKA age was 66.6 years (SD 9.6) with 62% being females (n = 85,163/137,969), while in the THA cohort the mean age was 64.7 years (SD 11.4) with 54% being female (n = 42,637/78,532). In both cohorts, preoperative hypoalbuminemia (< 35 g/l) was associated with a 1.5- and 1.8-times increased odds of 30-day readmission following TKA and THA, respectively. In TKA patients, decreased eGFR demonstrated the strongest association with acute readmission with a standardized odds ratio of 0.75 per two standard deviations increase (p < 0.0001). Conclusion In this population level cohort analysis of arthroplasty patients, low albumin demonstrated the strongest association with acute readmission in comparison to five other commonly ordered preoperative blood markers. Identification and optimization of preoperative hypoalbuminemia could help healthcare providers recognize and address at-risk patients undergoing TKA and THA. This is the most comprehensive and rigorous examination of the association between preoperative blood markers and readmission for TKA and THA patients to date. Cite this article: Bone Jt Open 2021;2(6):388–396.

show abstract

“…), так и хирургических (геморрагическая анемия, гематома и серома послеоперационной раны, раневая инфекция, нестабильность компонентов эндопротеза). В частности, R. Malpani с соавторами приводят данные о двукратно возрастающем риске развития осложнений при выполнении эндопроте-зирования ТБС у пациентов с ИТП [14]. По нашим данным, ОР всех осложнений в группе пациентов с тромбоцитопенией был в 5,2 раза выше.…”

Section: таблица 3 интраоперационные показатели у пациентов групп исс...unclassified

Total Hip Arthroplasty in Patients with Idiopathic Thrombocytopenic Purpura

Цед

Муштин

Dulaev³

2022

Traumatology and Orthopedics of Russia

View full text Add to dashboard Cite

Background There are no national clinical guidelines for the perioperative management of patients with idiopathic thrombocytopenia in hip arthroplasty. Most of the publications are presented in the context of general surgery, the distinguishing feature of which is the good achievement of hemostasis. However, it is impossible to achieve such a level of hemostasis with hip arthroplasty. The aim of the study was to evaluate the mid-term results of total hip arthroplasty in patients with primary idiopathic thrombocytopenia. Material and methods. Randomized monocenter clinical trial of 38 patients with idiopathic thrombocytopenia hip arthroplasty was performed. These patients constituted the main study group. As a comparison group, the outcomes of surgical treatment of 40 patients over the same observation period were analyzed. The mean follow-up period was 4.3 years. Exclusion criteria for the study were heparin-induced thrombocytopenia, a severe form of idiopathic thrombocytopenia in the acute stage with platelet counts less than 25*109/L. Results. The average length of hospitalization is longer among patients with idiopathic thrombocytopenia (11.1), it was possible to identify statistical significance of differences in the preoperative period. The results indicate a longer preoperative preparation, including the transfusion of hemocomponents with repeated monitoring of the parameters of the clinical blood test and coagulogram. There was no significant difference in the duration of the surgical intervention, but there were differences in the amount of intraoperative blood loss and the volume of blood transfusion. Among the patients of the control group (without idiopathic thrombocytopenia), only three patients required intraoperative transfusion of 1 dose of erythrocyte suspension, patients of the main group (thrombocytopenia) more often underwent blood transfusion. In the structure of complications in the first group, complications were noted in 5 patients, in the second group in one patient, which is not statistically significant (p=0.067), but the relative risk of complications was 5.2. Functional results 12 months after surgery do not differ. Conclusion. The mid-term results of hip arthroplasty are comparable to the results of arthroplasty in patients of the general population. A distinctive feature of surgical intervention is an increase in the average volume of intraoperative blood loss and the need for a significantly larger transfusion of hemocomponents not only during the operation, but also in the preoperative period, which increases the duration of hospitalization.

show abstract

Abnormally High, as Well as Low, Preoperative Platelet Counts Correlate With Adverse Outcomes and Readmissions After Elective Total Knee Arthroplasty

Cited by 26 publications

References 31 publications

Abnormal preoperative platelet count may predict postoperative complications following shoulder arthroplasty

Abnormal preoperative platelet count may predict postoperative complications following shoulder arthroplasty

The association of preoperative blood markers with postoperative readmissions following arthroplasty

Total Hip Arthroplasty in Patients with Idiopathic Thrombocytopenic Purpura

Contact Info

Product

Resources

About