Total Joint Arthroplasty in Patients With Atrial Septal Defects: What Are the 90-Day Complications?

Bido, Jennifer; Puri, Simarjeet; Salvati, Eduardo A.; Cross, Michael B.; Valle, Alejandro González Della; Gausden, Elizabeth B.

doi:10.1016/j.artd.2022.07.005

Cited by 2 publications

(1 citation statement)

References 19 publications

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“…The findings of our study were inconsistent with those found by Bido et al who reported zero embolic events within 90 days following TJA in a limited cohort of 160 patients with ASDs/PFOs 16 .…”

Section: Discussioncontrasting

confidence: 99%

Interatrial Wall Abnormality is Associated with Adverse Same-Admission Outcomes Following Total Knee Arthroplasty

Zhang,

Uddin,

Mai

et al. 2024

J Knee Surg

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Background: Total knee arthroplasty (TKA) is the most common joint arthroplasty procedure and is shown to be a reliable and efficacious way to improve quality of life. Individuals with inter-atrial wall abnormalities (IAWAs), such as atrial septal defect (ASD) or patent foramen ovale (PFO), are at increased baseline risk for stroke and overall lifetime morbidity. The purpose of our study was to elucidate the association between IAWAs and perioperative TKA outcomes. Methods: We performed a retrospective cohort study utilizing the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) database. Admissions for TKA between 2010 and 2019 were identified using the ICD-9 and ICD-10 procedure codes. Patients with ICD-9-CM diagnosis code 7455 or ICD-10-CM diagnosis code Q211 were assigned to the IAWA cohort, the primary exposure. Confounding variables included basic demographics, baseline health status, and surgical facility characteristics. The primary outcomes studied were medical complications, implant-related complications, and admission mortality. Univariate and adjusted multivariable regression analyses were used for identifying associations. Results: Compared to patients in the non-IAWA cohort, those in the IAWA cohort had significant risks for same-admission medical complications (OR 5.77, 95% CI 4.59 to 7.15; p<0.001), implant-related complications (OR 1.55, 95% CI 1.09 to 2.12; p=0.009), stroke (OR 77.46, 95% CI 58.4 to 101.2; p<0.001), venous thromboembolism (VTE) (OR 3.78 95% CI 2.47 to 5.51; p<0.001), and mortality (OR 8.36 95% CI 3.54 to 16.52; p<0.001) following TKA. Conclusions: Compared to patients without IAWS, those with IAWAs who undergo TKA have higher risks for same-admission medical and implant-related complications as well as same-admission mortality. Similarly, these patients have higher risks for same-admission stroke and venous thromboembolism. Further research in management of patients with IAWAs undergoing TKA is needed. Level of Evidence: Level III: Retrospective Cohort Study

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Section: Discussioncontrasting

confidence: 99%