RISK-PROFILING IN KNEE ARTHROPLASTY BASED ON POSTOPERATIVE COMPLICATIONS OF 17644 ARTHROPLASTIES

Abstract

Introduction: Risk-profiling of patients in knee arthroplasty to prepare for postoperative complications is becoming more important.

Materials and Methods: Major complications (hematoma, cardio-vascular complication, deep venous thrombosis, pulmonary embolism, joint infection and pneumonia) following 17644 knee arthroplasties occurring within the postoperative hospitalization period have been documented based on a standardized protocol used for external quality assessment in Germany. Using logistic regression, the influence of potential risk factors were assessed for their significance on postoperative complications and uni-variate analysis used to assess this influence on every single major complication. The influence of patient age and the surgery time on major complications were calculated using ANOVA.

Results: Major postoperative complications occurred in 7.22 per cent with hematoma in 2.89, cardio-vascular complications in 1.79, deep venous thrombosis in 1.23, pulmonary embolism in 0.23, joint infection in 0.82 and pneumonia in 0.25 per cent. Patient age, surgery time, gender, high classification according to the American Association of Anesthesiologists, allogeneic blood transfusion and lateral release significantly increased the rate of postoperative complications. Males are more prone to suffer from hematoma, joint infection and pneumonia in the immediate postoperative course. Females are more endangered for deep venous thrombosis. Extended surgery time increased the rate of hematoma and infection, increased patient age elevated the rate of hematoma, cardiovascular complication and pneumonia. Alloge-neic blood transfusion increased the risk of all major complications except deep venous thrombosis.

Conclusions Male gender, allogeneic blood transfusion, increased age and surgery time elevate immediate postoperative complications following knee arthroplasty.