Risk factors associated with cardiac complication after total joint arthroplasty of the hip and knee: a systematic revie
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(2019) 14:15
SYSTEMATIC REVIEW
Open Access
Risk factors associated with cardiac complication after total joint arthroplasty of the hip and knee: a systematic review Yassin Elsiwy1,2, Ivana Jovanovic1, Kenji Doma1,3, Kaushik Hazratwala1 and Hayley Letson2*
Abstract Background: Cardiac complication represents a major cause of morbidity and mortality after total joint arthroplasty, thus necessitating investigation into the associated risks in total hip arthroplasty and total knee arthroplasty. There remains a lack of clarity for many risk factors in the current literature. The aim of this systematic review is to assess the most recent published literature and identify the risk factors associated with cardiac complication in total hip arthroplasty and total knee arthroplasty. Methods: Scopus, PubMed, CINHAL, and Cochrane were searched to identify studies published since 2008 reporting on risk factors associated with cardiac complication in elective primary in total hip arthroplasty and total knee arthroplasty in patients ≥18 years old with osteoarthritis. Reported odds ratios, hazard ratios, and relative risk were the principal summary measures collected. The included studies were too heterogeneous to enable meta-analysis. Results: Fifteen studies were included in this systematic review. Increasing age and history of cardiac disease were found by most studies to be positively associated with risk of cardiac complication. There was no strong association found between obesity and cardiac complication. The evidence for other risk factors was less clear in the examined literature, although there is suggestive evidence for male gender and cerebrovascular disease increasing risk. Conclusions: Increasing age and history of cardiac disease increases the risk of cardiac complication after total hip arthroplasty and total knee arthroplasty. Other risk factors commonly attributed to increased risk in non-cardiac surgery including hypertension and obesity require further evaluation in arthroplasty. Systematic review registration: A detailed protocol was published in the PROSPERO database (registration number CRD42018095887) for this systematic review. Keywords: Cardiac, Arthroplasty, TKA, THA, Risk factor, Complication
Introduction Total hip arthroplasty (THA) and total knee arthroplasty (TKA) is the definitive surgical treatment for osteoarthritis (OA) of the hip and knee to improve quality of life, alleviate pain, and enhance function [1–3]. It is predicted that by 2030, there will be a 174% and 673% growth for THA and TKA respectively, with a projected 4 million total joint arthroplasties (TJA) annually in the USA [4–6]. Although TJA is considered a relatively safe procedure with reported rates of major cardiac complication as low * Correspondence: [email protected] 2 College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia Full list of author information is available at the end of the article
as 0.2 to 0.8%, this risk becomes increasingly significant when considering the substantial inc
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