4.6 Article

Predictors of Intensive Care Unit Admission After Total Joint Arthroplasty

Journal

JOURNAL OF ARTHROPLASTY
Volume 27, Issue 5, Pages 720-725

Publisher

CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.arth.2011.09.027

Keywords

total joint arthroplasty; intensive care unit; smoking; cemented arthroplasty; general anesthesia

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Total joint arthroplasty (TJA) is a relatively safe orthopedic procedure. However, complications do occur, and some may necessitate admission to the intensive care unit (ICU). Our purpose was to determine risk factors associated with admittance to ICU after TJA. We evaluated 22 343 primary and revision total hip and knee arthroplasties from 1999 to 2008. One hundred thirty patients were admitted to the ICU. Cases were matched 1:2 for date of surgery, surgeon, and type of surgery. The causes for admission to ICU were recorded. Independent risk factors for ICU admission were smoking, cemented arthroplasty, general anesthesia, allogenic transfusion, higher C-reactive protein, lower hemoglobin level, higher body mass index, and older age. Proper identification and management of these at-risk patients may decrease the incidence of ICU admittance after TJA.

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