Perioperative morbidity and mortality of same-day bilateral TKAs: incidence and risk factors. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Controversy persists regarding the safety of same-day bilateral TKAs, and indications for same-day versus staged bilateral surgery need to be clarified. QUESTIONS/PURPOSES: We compared the (1) 30-day mortality, (2) rates of in-hospital complications, (3) in-hospital charges, and (4) risk factors for complications among patients undergoing same-day and staged bilateral TKAs at two separate admissions within 1 year either less than 3 months apart (staged 0-3) or more than 3 months apart (staged 3-12) at an institution where same-day bilateral TKAs were discouraged in patients with more severe medical comorbidities. METHODS: We analyzed institutional data from 3960 same-day, 172 staged 0-3, and 1533 staged 3-12 bilateral TKAs performed between 1998 and 2011. Patient demographics, comorbidities, and 30-day mortality were tabulated. Same-day patients were younger and healthier. Outcomes of interest included complications, blood transfusions, transfer to rehabilitation, and in-hospital charges. Regression models were conducted to identify independent risk factors for major morbidity or mortality. RESULTS: There were no differences in 30-day mortality among groups. The same-day group experienced more acute postoperative anemia, blood transfusions, and transfers to rehabilitation, but otherwise had complications comparable to those of the staged groups. In-hospital charges were lower in the same-day group. Congestive heart failure and pulmonary hypertension were the most significant factors associated with morbidity and mortality in the same-day group. CONCLUSIONS: In a high-volume subspecialty setting in which patients undergoing same-day bilateral TKAs were generally much healthier and younger, we found that same-day bilateral TKAs appeared to be safe.

publication date

  • January 1, 2014

Research

keywords

  • Arthroplasty, Replacement, Knee
  • Osteoarthritis, Knee

Identity

PubMed Central ID

  • PMC3889452

Scopus Document Identifier

  • 84891737383

Digital Object Identifier (DOI)

  • 10.1007/s11999-013-3156-7

PubMed ID

  • 23836245

Additional Document Info

volume

  • 472

issue

  • 1