Anemia, decompensated diabetes and poor functional situation, act as independent factors of worse outcomes in total knee arthroplasties
ESSKA Academy. Nicolau Miralles B. 11/08/19; 285249; epEKA-70 Topic: Joint Replacement
Barbara Nicolau Miralles
Barbara Nicolau Miralles
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Abstract
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Introduction: The impact of certain comorbidities has been studied as a risk factor for perioperative complications and mortality after total knee arthroplasties (TKA). Despite this, its short and long term clinical outcomes influence has not been analyzed.
Objective: To analyze the influence of obesity, diabetes, patient's clinical situation and preoperative anemia at short-medium term clinical outcomes of TKA.
Materials and methods: A study of 595 patients (438 women) operated of TKA was carried out between 2011 and 2016, with a follow-up of 2.9 ± 1.8 years.
The following variables were analized: age, sex, ASA, BMI, hemoglobin (Hb) and glycemia (Gli) preoperatively and at 24 hours postoperatively. The Knee Society Score (KSS) and McMaster Universities Osteoarthritis Index (WOMAC) were evaluated preoperatively and postoperatively for each patient
The normal distribution of the variables was assessed by the Kolmogorov-Smirnov test. Variables were grouped according to postoperative KSS and WOMAC scores and were analyzed by ANOVA test and with the T2-Tamahne post-hoc test. The homogeneity of the variances was assessed by the Levene test.
All analyzes were carried out using the program IBM® SPSS® version 24.0 (Armonk, NY: IBM Corp. USA) and p-value was established at < 0.05.
Results: Low levels of pre-Hb (F: 4.331, P < 0.005), Hb 24 post (F: 3.262, P < 0.021) and low scores at pre-KSS (F: 4.363, P < 0.005) were found to be associated with poorer results at postoperative KSS.
Low levels of pre-Hb (F: 3.031, P < 0.029), high levels of Glycemia pre (F: 3.425, P < 0.017), low values ​​of pre KSS (F: 3,394, P < 0.019), and high scores in WOMAC pre (F: 4,210; P < 0.007) were related to worse postoperative WOMAC results.
Regarding the other variables studied (age, sex, BMI, ASA) no influence was established with clinical outcome.
Conclusions: Anemia, decompensated diabetes and a poor preoperative clinical and functional situation are independently associated with worse short-term clinical outcomes after a TKA. This study supports the theory of the importance of prior optimization of patients before surgery in order to obtain better short-term clinical outcomes.
Introduction: The impact of certain comorbidities has been studied as a risk factor for perioperative complications and mortality after total knee arthroplasties (TKA). Despite this, its short and long term clinical outcomes influence has not been analyzed.
Objective: To analyze the influence of obesity, diabetes, patient's clinical situation and preoperative anemia at short-medium term clinical outcomes of TKA.
Materials and methods: A study of 595 patients (438 women) operated of TKA was carried out between 2011 and 2016, with a follow-up of 2.9 ± 1.8 years.
The following variables were analized: age, sex, ASA, BMI, hemoglobin (Hb) and glycemia (Gli) preoperatively and at 24 hours postoperatively. The Knee Society Score (KSS) and McMaster Universities Osteoarthritis Index (WOMAC) were evaluated preoperatively and postoperatively for each patient
The normal distribution of the variables was assessed by the Kolmogorov-Smirnov test. Variables were grouped according to postoperative KSS and WOMAC scores and were analyzed by ANOVA test and with the T2-Tamahne post-hoc test. The homogeneity of the variances was assessed by the Levene test.
All analyzes were carried out using the program IBM® SPSS® version 24.0 (Armonk, NY: IBM Corp. USA) and p-value was established at < 0.05.
Results: Low levels of pre-Hb (F: 4.331, P < 0.005), Hb 24 post (F: 3.262, P < 0.021) and low scores at pre-KSS (F: 4.363, P < 0.005) were found to be associated with poorer results at postoperative KSS.
Low levels of pre-Hb (F: 3.031, P < 0.029), high levels of Glycemia pre (F: 3.425, P < 0.017), low values ​​of pre KSS (F: 3,394, P < 0.019), and high scores in WOMAC pre (F: 4,210; P < 0.007) were related to worse postoperative WOMAC results.
Regarding the other variables studied (age, sex, BMI, ASA) no influence was established with clinical outcome.
Conclusions: Anemia, decompensated diabetes and a poor preoperative clinical and functional situation are independently associated with worse short-term clinical outcomes after a TKA. This study supports the theory of the importance of prior optimization of patients before surgery in order to obtain better short-term clinical outcomes.
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