Document Detail


Frequency of myocardial infarction, pulmonary embolism, deep venous thrombosis, and death following primary hip or knee arthroplasty.
MedLine Citation:
PMID:  11981154     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: There is limited information about the frequency of perioperative complications after elective primary orthopedic total hip and knee arthroplasty in contemporary practice. The purpose of this study was to determine the frequency of clinically relevant myocardial infarction, pulmonary embolism, deep venous thrombosis, and death within 30 days after elective primary hip or knee arthroplasty treated according to contemporary perioperative management. METHODS: The authors examined the medical records of consecutive patients undergoing hip or knee arthroplasty at their institution in a 10-yr period. Prospectively collected databases were used to identify patients with the diagnosis of myocardial infarction, pulmonary embolism, deep venous thrombosis, or death using strict validation criteria and diagnostic-certainty categories. RESULTS: A total of 10,244 patients underwent primary total hip or knee arthroplasty in the period of study. Of these, 224 patients had one or more adverse events (overall event rate: 2.2%; myocardial infarction: 0.4%; pulmonary embolism: 0.7%; deep venous thrombosis: 1.5%; death: 0.5%). Most adverse events (myocardial infarction, pulmonary embolism, and death) increased in frequency with older age, particularly for patients aged 70 yr or older. Myocardial infarction occurred more frequently in male patients. There were no differences in the overall event frequency between types of procedure. However, pulmonary embolism was highest in patients undergoing bilateral knee operations. CONCLUSIONS: The overall frequency of serious complications within 30 days after primary total hip or knee arthroplasty with contemporary practice was 2.2%. Accurate knowledge of the perioperative risks associated with widely performed elective operations can be used to implement management strategies that may further improve patient outcomes and decrease cost.
Authors:
Carlos B Mantilla; Terese T Horlocker; Darrell R Schroeder; Daniel J Berry; David L Brown
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  96     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-04-30     Completed Date:  2002-05-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1140-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Health Sciences Research, and Orthopedic Surgery, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA. mantilla.carlos@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Arthroplasty, Replacement, Hip / adverse effects*,  economics,  mortality*
Arthroplasty, Replacement, Knee / adverse effects*,  economics,  mortality*
Databases, Factual
Female
Humans
Male
Middle Aged
Myocardial Infarction / economics,  epidemiology*,  mortality
Postoperative Complications / economics,  epidemiology*,  mortality*
Pulmonary Embolism / economics,  epidemiology*,  mortality
Registries
Sex Factors
Venous Thrombosis / economics,  epidemiology*,  mortality
Comments/Corrections
Erratum In:
Anesthesiology 2002 Aug;97(2):531

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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