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Mental health conditions present strong predictive effect for serious complications after TJA
Among patients undergoing total joint arthroplasty, mental health conditions demonstrated a strong predictive effect for serious complications and should be included in a risk-adjustment tool, according to study results.
Researchers collected demographic data, preoperative comorbidities, intraoperative surgical measures, lengths of hospital stays, postoperative complications and 30-day readmissions among 5,314 patients who underwent total hip or knee arthroplasty from October 2008 through September 2011.
Primary endpoints included incidence of reoperation during same admission; length of stay longer than 4 days; readmission within 30 days post-surgery and the incidence of postoperative orthopedic, major nonorthopedic or minor nonorthopedic complications.
Study results showed the overall incidence of the primary endpoints was 3.8%. Patients with preexisting psychiatric conditions, including delirium, dementia or depressive psychosis, had the highest risk ratios predictive of postoperative complications and extended lengths of hospital stay.
The researchers found a history of venous thromboembolism was a significant predictor for postoperative major nonorthopedic complications and genitourinary conditions, such as urinary tract infection/urinary retention or chronic renal failure, were also significant predictors for postoperative complications.
Prolonged operating time was a significant predictor for extended length of stay, readmissions and complications when analyzed as a continuous variable, according to the researchers.
Disclosure: See the study for a full list of all authors’ relevant financial disclosures.