The Effect of Chronic Kidney Disease on Total Hip Arthroplasty

Miric, Alexander; Inacio, Maria C.S.; Namba, Robert S.

doi:10.1016/j.arth.2013.12.031

Cited by 58 publications

(43 citation statements)

References 35 publications

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“…Miric et al [12] investigated chronic kidney disease as potential risk factor for superficial SSI after THA. They found no predisposition for superficial infection related to this medical condition (HR: 1.13; CI: 0.49 -2.60; p = 0.771).…”

Section: Resultsmentioning

confidence: 99%

Risk Factors for Superficial Side Infections after Total Hip Arthroplasty

Annabelle¹,

Windhager²,

Pilz³

et al. 2018

ujmsj

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As the numbers of primary total joint replacements and following revision operations are constantly rising, there are more and more patients with severe comorbidities, which might be considered as additional risk factor for developing a periprosthetic joint infection (PJI). In this study, we analyzed patient-related risk factors, which might influence the occurrence of superficial surgical side infections (SSI) after total hip replacements. There is no study yet, focusing only on superficial SSI rather than on deep infections or PJI in general. Methods: We performed a literature research in Pubmed. Used key words were "hip AND (arthroplasty OR replacement) AND infection." We found 4,417 studies related to this broad definition. After exclusion by defined criteria, 10 relevant studies were left. Results: We found the following patient-related risk factors for superficial SSI: Obesity, age, ASA class >2, diabetes mellitus, HIV, hypertension, chronic obstructive pulmonary disease (COPD), previous cardiac surgery, dyspnea, corticosteroid use and hepatitis C. Gender, race and chronic kidney disease were not confirmed as risk factors for superficial SSI. Conclusions: To guarantee the best possible outcome after the surgery, it is advisable to treat these patients before performing a total hip replacement-if possible.

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Section: Resultsmentioning

confidence: 99%

Risk Factors for Superficial Side Infections after Total Hip Arthroplasty

Annabelle¹,

Windhager²,

Pilz³

et al. 2018

ujmsj

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“…Recent studies have shown the prevalence of chronic kidney disease in an elective arthroplasty setting to be between 6% and 27% of patients [5,9,18]. Bozic et al [7,19] have previously shown that renal disease is an independent risk factor for early revision after primary hip and knee arthroplasty, as well as periprosthetic joint infection.…”

Section: Discussionmentioning

confidence: 97%

“…In a comparatively small cohort of 526 patients, Ackland et al [5] found that patients with CKD had increased pulmonary, infectious, and cardiovascular complications while experiencing an increased length of stay of 4 days. Miric et al [9,18] found an increased risk for 90-day readmission for both THA and TKA patients in the setting of CRD. Pugely et al [10] corroborated these findings, showing that dialysis, high serum BUN, and elevated serum creatinine were predictive risk factors for 30-day readmission.…”

Section: Discussionmentioning

confidence: 97%

“…Patients with chronic renal disease (CRD) have significant cardiovascular comorbidities and reduced long-term survival in proportion to the severity of renal disease [4]. Chronic renal disease has been previously associated with high complications after total joint arthroplasty [5][6][7][8][9][10]. While recognized as a risk factor, the degree to which severity of co-morbid renal dysfunction plays a role in negative perioperative outcomes has not been well quantified.…”

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confidence: 99%

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Total Joint Arthroplasty in Patients with Chronic Renal Disease: Is It Worth the Risk?

Warth

Pugely

Martin

et al. 2015

The Journal of Arthroplasty

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“…Chronic kidney disease is common in adults older than 65 years, who are the fastest growing subset of patients with end-stage renal disease. 23 While studies have shown that THA and TKA can be performed safely in this patient cohort, 24,25 close attention must be paid to mitigate the perioperative risks associated with chronic renal disease.…”

Section: Discussionmentioning

confidence: 99%

Not all total joint replacement patients are created equal: preoperative factors and length of stay in hospital

et al. 2015

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Not all total joint replacement patients are created equal: preoperative factors and length of stay in hospital Background: We conducted a cross-sectional study of primary total joint replacement (TJR) patients to determine predictors for prolonged length of stay (LOS) in hospital to identify patient characteristics that may inform resource allocation, accounting for patient complexity.Methods: Preoperative demographics, medical comorbidities and acute hospital LOS from a consecutive series of primary TJR patients from an academic arthroplasty centre were abstracted. We categorized patients as LOS of 3 or fewer days, 4 days, or 5 or more days to align results with varying LOS benchmarks. To identify predictors for LOS, we used a generalized logistic regression model fitted on an LOS ternary outcome, using LOS of 3 or fewer days as a reference category. Results:The sample included 1459 patients: 61.7% total knee and 38.3% total hip. Conclusion:Not all patients undergoing TJR are equal. The goal should be individual patient-focused care rather than a predetermined LOS that is not achievable for all patients. Hospital resource planning must account for patient complexity when planning future bed management.Contexte : Nous avons réalisé une étude transversale auprès de patients soumis à une chirurgie pour prothèse articulaire totale (PAT) afin de déterminer les facteurs pré-dictifs d'une durée du séjour hospitalier (DSH) prolongée (en établissement de soins de courte durée) et de dégager les caractéristiques des patients qui permettraient d'orienter l'allocation des ressources en tenant compte de la complexité des cas.Méthodes : Nous avons extrait les données démographiques préopératoires, les comorbidités médicales et la DSH pour une série de cas consécutifs de PAT primaire dans un centre d'arthroplastie universitaire. Nous avons classé les patients par catégorie de DSH, soit 3 jours ou moins, 4 jours, ou 5 jours et plus, de manière à répartir les résultats selon les diverses cibles de DSH. Pour dégager les facteurs prédictifs de la DSH, nous avons utilisé un modèle de régression logistique généralisé intégré à un paramètre ternaire de DSH, en utilisant la DSH de 3 jours ou moins comme catégorie de référence. Conclusion :Les patients soumis à une PAT ne s'équivalent pas tous. L'objectif devrait être d'administrer des soins centrés sur le patient plutôt que sur une DSH pré-déterminée qui, dans les faits, ne s'applique pas à tous patients. La planification des ressources hospitalières devra à l'avenir tenir compte de la complexité des cas dans la planification de la gestion des lits.

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The Effect of Chronic Kidney Disease on Total Hip Arthroplasty

Cited by 58 publications

References 35 publications

Risk Factors for Superficial Side Infections after Total Hip Arthroplasty

Risk Factors for Superficial Side Infections after Total Hip Arthroplasty

Total Joint Arthroplasty in Patients with Chronic Renal Disease: Is It Worth the Risk?

Not all total joint replacement patients are created equal: preoperative factors and length of stay in hospital

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