School of Medicine and Health Sciences Poster Presentations

Title

The Impact of COPD on Peri- and Post-Operative Comorbidity and Complications in Patients Undergoing Revision Total Knee Arthroplasty

Poster Number

167

Document Type

Poster

Status

Graduate Student - Doctoral

Abstract Category

Rehabilitation and Recovery

Keywords

knee, arthroplasty, revision, primary, COPD, obstructive, pulmonary, complications

Publication Date

Spring 2018

Abstract

Background: Total knee arthroplasty (TKA) is currently one of the most prevalent orthopedic procedures in the United States used to treat a wide variety of orthopedic conditions and is increasingly more popular among aging Americans. Chronic obstructive pulmonary disease incidence has been steadily rising over the past few decades and it is currently one of the leading causes of death worldwide. Given the increased prevalence of COPD among the aging and elderly, the disease is becoming more common in TKA surgical candidates. Because of this, it is important to understand the impact and relationship of the disease on a broad array of peri- and post-operative comorbidities and complications so that surgeons may more appropriately assess pre-operative risk. Methods: A retrospective cohort study was conducted using data collected through the American College of Surgeons National Quality Improvement Program Database. All patients who underwent revision TKA between 2007 and 2014 were identified. These patients were stratified into groups based on the presence or absence of COPD (without COPD = 9370 [94.4%]; with COPD = 551 [5.6%]). The incidence of adverse events following surgery was evaluated with univariate and multivariate analyses where appropriate. Results: This study used 9,921 subjects who underwent revision TKA. A total of 551 patients had COPD [5.6%] and 9,370 did not [94.4%]. Patients with COPD were found to have increased risk of 8 of 9 peri-operative comorbidities and increased risk of 14 of 18 independent post-operative complications as well as increased risk of all-cause post-operative complications. COPD was also found to be an independent risk factor for unplanned return to the OR. Conclusion: Patients with COPD undergoing revision TKA have greater risk for peri- and post-operative comorbidity and complications than those without COPD, with a 28% overall risk for all-cause complications. While risks for independent complications remain relatively low, consideration of COPD status is an important factor to consider when selecting surgical candidates.

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The Impact of COPD on Peri- and Post-Operative Comorbidity and Complications in Patients Undergoing Revision Total Knee Arthroplasty

Background: Total knee arthroplasty (TKA) is currently one of the most prevalent orthopedic procedures in the United States used to treat a wide variety of orthopedic conditions and is increasingly more popular among aging Americans. Chronic obstructive pulmonary disease incidence has been steadily rising over the past few decades and it is currently one of the leading causes of death worldwide. Given the increased prevalence of COPD among the aging and elderly, the disease is becoming more common in TKA surgical candidates. Because of this, it is important to understand the impact and relationship of the disease on a broad array of peri- and post-operative comorbidities and complications so that surgeons may more appropriately assess pre-operative risk. Methods: A retrospective cohort study was conducted using data collected through the American College of Surgeons National Quality Improvement Program Database. All patients who underwent revision TKA between 2007 and 2014 were identified. These patients were stratified into groups based on the presence or absence of COPD (without COPD = 9370 [94.4%]; with COPD = 551 [5.6%]). The incidence of adverse events following surgery was evaluated with univariate and multivariate analyses where appropriate. Results: This study used 9,921 subjects who underwent revision TKA. A total of 551 patients had COPD [5.6%] and 9,370 did not [94.4%]. Patients with COPD were found to have increased risk of 8 of 9 peri-operative comorbidities and increased risk of 14 of 18 independent post-operative complications as well as increased risk of all-cause post-operative complications. COPD was also found to be an independent risk factor for unplanned return to the OR. Conclusion: Patients with COPD undergoing revision TKA have greater risk for peri- and post-operative comorbidity and complications than those without COPD, with a 28% overall risk for all-cause complications. While risks for independent complications remain relatively low, consideration of COPD status is an important factor to consider when selecting surgical candidates.