Key result
Total joint alloplasty patients show high CV risk, with hypertension present in ~56%.
Why the study?
Classical and non-classical cardiovascular risk factors in patients undergoing total hip or knee alloplasty are not well established despite the high perioperative risk and complication rates.
Observational (n=90)
Patients undergoing total joint alloplasty have a high prevalence of cardiovascular risk factors, emphasizing the importance of thorough perioperative cardiovascular risk assessment.
CV risk factors exceed general population rates in joint replacement candidates; hypothesis-generating for perioperative screening impact.
BACKGROUND: Risk assessment is of particular importance for patients undergoing surgical interventions. Orthopaedic procedures, especially total joint alloplasty, are major procedures associated with high perioperative risk, as well as one of the highest rates of complications. AIM: The aim of the present study was to establish the prevalence of classical and non-classical cardiovascular risk factors in patients undergoing total hip or knee alloplasty. METHODS: The CRASH-JOINT (Cardiovascular Risk Assessment ScHeme in JOINT alloplasty) was a prospective, epidemiological study performed in consecutive patients scheduled for total joint (hip or knee) replacement surgery. Patients enrolled into the study were screened for cardiovascular risk factors and had ambulatory blood pressure performed for the diagnosis of hypertension. RESULTS: The present study enrolled 98 patients. During initial screening eight patients were disqualified from the study and the surgery, in the majority due to the cardiac causes. Sixty-five patients had a hip joint replacement and 25 had knee joint replacement (mean age 63.7 ± 12.2 years, 62.2% female). Fifty (55.6%) patients were diagnosed with arterial hypertension in the past, ten (11.1%) patients had diabetes mellitus, two (2.2%) had a history of myocardial infarction, and family history of cardiovascular disease was present in 24 (26.7%) cases. Mean body mass index (BMI) was 28.0 ± 5.1 kg/m² and 39 (43.3%) patients were overweight, while 28 (31.1%) were obese. Patients undergoing hip replacement were significantly younger (61.8 ± 12.6 vs. 68.5 ± 10.0 years; p = 0.02), were more often current smokers (24.6% vs. 4.0%; p = 0.03), had significantly lower BMI (26.8 ± 4.5 vs. 31.2 ± 5.3 kg/m²; p < 0.0001), and were less often obese (18.5% vs. 64.0%; p < 0.0001). There were no significant differences between patients scheduled for primary surgery and reoperation. CONCLUSIONS: The study showed that classical cardiovascular risk factors in patients undergoing total hip or knee alloplasty have a higher prevalent than in the general population, which can potentially contribute to the higher risk of development of perioperative complications.
No takes yet. Share an insight, caveat, or question.
Łęgosz et al. (2016) conducted an observational in Patients undergoing total hip or knee alloplasty (n=90). Total hip or knee alloplasty vs. General population (implied) / Hip vs Knee comparison was evaluated on Prevalence of classical and non-classical cardiovascular risk factors. Patients undergoing total joint alloplasty had a high prevalence of cardiovascular risk factors, including hypertension (55.6%) and obesity (31.1%), with obesity being more common in knee versus hip replacement (64.0% vs 18.5%, P<0.0001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: