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- Title
Parkinson's disease increases the risk of perioperative complications after total knee arthroplasty: a nationwide database study.
- Authors
Newman, Jared M.; Sodhi, Nipun; Wilhelm, Alyeesha B.; Khlopas, Anton; Klika, Alison K.; Naziri, Qais; Kryzak, Thomas J.; Higuera, Carlos A.; Mont, Michael A.
- Abstract
<bold>Purpose: </bold>Therefore, the purpose of this study was to evaluate the short-term perioperative outcomes of PD patients who underwent total knee arthroplasty (TKA). We specifically evaluated: (1) perioperative surgical and medical complications; (2) lengths of stay (LOS); and (3) total hospital charges.<bold>Methods: </bold>The Nationwide Inpatient Sample was used to identify PD patients who underwent TKA between 2002 and 2013. To control for potential confounders, PD TKA and non-PD TKA patients were propensity score matched (1:3) based on age, sex, ethnicity, Charlson Comorbidity Index, and insurance type. A total of 31,979 PD and 95,596 non-PD TKA patients were included.<bold>Results: </bold>PD patients had a 44% higher risk of suffering from any complication (OR 1.44; 95% CI 1.35-1.54), a 45% increased risk for any medical complication (OR 1.45; 95% CI 1.36-1.55), and a 9% higher risk for any surgical complication (OR 1.09; 95% CI 0.84-1.41). Compared to the matched cohort, PD patients had a mean LOS that was 6.5% longer (95% CI 5.46-7.54) and mean total hospital charges that were 3.05% higher (95% CI 1.99-4.11).<bold>Conclusions: </bold>PD patients are more likely to have postoperative complications, longer LOS, and higher costs after TKA than non-PD TKA patients. Since many of these complications can be prevented, a team-based multi-specialty patient optimization is needed.<bold>Level Of Evidence: </bold>Level III, therapeutic study.
- Subjects
TOTAL knee replacement; PERIOPERATIVE care; SURGICAL complications; ARTHROPLASTY; KNEE surgery; PARKINSON'S disease; COMORBIDITY; DATABASES; LENGTH of stay in hospitals; LONGITUDINAL method; PROBABILITY theory; CASE-control method; DISEASE complications
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2019, Vol 27, Issue 7, p2189
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-018-4970-y