Journal
JOURNAL OF ARTHROPLASTY
Volume 36, Issue 8, Pages 2974-2979Publisher
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.arth.2021.03.005
Keywords
total joint arthroplasty; gastrointestinal; complication; morbidity; mortality
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The study identified modifiable risk factors for the development of GI complications following TJA, including older age, non-alcohol use, and several comorbidities. Patients with GI complications required longer hospital stays, greater post-acute care resources, and had a substantially higher risk of mortality.
Background: Gastrointestinal (GI) complications following total joint arthroplasty (TJA) are rare, but can result in substantial morbidity and mortality, especially when intervention is required. The purpose of this study is to identify modifiable risk factors for the development of GI complications and determine their impact on short-term outcomes following TJA. Methods: We queried patients who underwent primary TJA at a single academic center from 2009 through 2018 and collected data on demographics, comorbidities, operative and perioperative details, and short-term outcomes. Patients who suffered at least one GI complication during the same hospitalization as their TJA were identified. The type of GI complication and intervention performed, if necessary, was recorded. Variables that independently affected the risk of GI complication were identified. Multivariate regression was performed to determine the effect suffering a GI complication had on outcomes. Results: Of 17,402 patients, 106 (0.6%) suffered a GI complication. Constipation/obstruction, followed by diarrhea/malabsorption, hemorrhage, and Clostridium difficile were the most commonly reported complications. Patients suffering a GI complication were significantly older (68.5 vs 63.7, P < .001), less likely to use alcohol (49% vs 65%, P = .008), and had higher incidences of 8 of the 16 comorbidities analyzed (all P < .05). Patients with GI complications had greater lengths of stay (13.2 vs 2.3 days, P < .001), discharge to facility rates (58% vs 16%, P < .001), and in-hospital mortality rates (1.9% vs 0.1%, P = .002). Conclusion: Patients suffering a GI complication following TJA require longer hospital stays and greater post-acute care resources and have a substantially higher risk of mortality. (C) 2021 Elsevier Inc. All rights reserved.
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