Journal article
Systemic Lupus Erythematosus is a Risk Factor for Complications in Total Joint Arthroplasty
The Iowa orthopaedic journal, Vol.38, pp.183-190
2018
PMCID: PMC6047393
PMID: 30104943
Appears in Diamond Open Access
Abstract
Introduction: Systemic Lupus Erythematosus (SLE) has been associated with increased complications following hip and knee arthroplasty. The Purpose of this study was to determine the extent to which SLE is a risk factor in outcomes following total joint arthroplasty (TJA).
Methods: The nationwide inpatient sample was used to identify a cohort of 505,841 patients who had a total hip arthroplasty (THA) or total knee arthroplasty (TKA) between 2009-2011. Of these patients, 2,284 patients (0.45%) had been previously diagnosed with SLE. The impact of SLE on short-term TJA outcomes was determined using multivariate logistic regression. Differences in discharge destination and length of stay were also evaluated.
Results: SLE patients were more likely to have an all-cause medical complication, (OR 1.9, p<0.0001) and more likely to have an all-cause surgical complication (OR 1.3, p<0.0001). SLE patients were four times more likely to become septic in the post-operative period (OR 3.8, p<0.0487). SLE patients were more likely to have a genitourinary complication (OR 1.7, p<0.0001) and bleeding complications requiring transfusion (OR 2.1, p<0.0001). Patients with SLE also had an increased length of stay (0.38 days, p<0.0001) and increased probability of discharging to a facility (OR 2.1, p<0.0001).
Discussion: Patients with SLE had an increased rate of both medical and surgical all-cause complications. Patients were specifically found to be at higher risk for sepsis, genitourinary complications, and blood transfusions. Future risk adjustment models should include SLE as a contributor to medical and surgical complications in the postoperative period.
Keywords: Nationwide Inpatient Sample (NIS); SLE; Total hip arthroplasty; sepsis; short-term complications; systemic lupus erythematosus; total knee arthroplasty.
Details
- Title: Subtitle
- Systemic Lupus Erythematosus is a Risk Factor for Complications in Total Joint Arthroplasty
- Creators
- J. Joseph GholsonBrandon G WilkinsonTimothy S BrownYubo GaoS. Blake DowdleJohn J Callaghan
- Resource Type
- Journal article
- Publication Details
- The Iowa orthopaedic journal, Vol.38, pp.183-190
- Publisher
- Dept. of Orthopaedics, The University of Iowa; United States
- PMID
- 30104943
- PMCID
- PMC6047393
- ISSN
- 1541-5457
- eISSN
- 1555-1377
- Language
- English
- Date published
- 2018
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Internal Medicine
- Record Identifier
- 9984040445002771
Metrics
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