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Cardiac Risk Index score predicted postoperative cardiac complications after THA, TKA
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Recently published results showed use of the total joint arthroplasty Cardiac Risk Index score successfully predicted postoperative cardiac complications after primary total hip and knee arthroplasty.
Using the National Surgical Quality Improvement data set, researchers identified 85,129 patients who underwent either primary total knee arthroplasty (TKA) or total hip arthroplasty (THA). Researchers evaluated age 80 years or older, history of hypertension and history of cardiac disease as predictors of myocardial infarction and cardiac arrest with stepwise multivariate logistic regression. To identify the influence of each variable on 30-day postoperative cardiac events, researchers constructed and weighted a series of predictive scores and compared them with the Revised Cardiac Risk Index.
Results showed statistically significant predictors of postoperative cardiac events after THA and TKA included age 80 years or older, hypertension and a history of cardiac disease. The highest discriminative capacity in both THA and TKA cohorts was maintained by equal weighing of all variables, according to results. Researchers noted, for patients who underwent THA and TKA, 75% and 71% of the variation in postoperative cardiac events were explained by adjusted models, respectively, without statistically significant lack of fit. Although the Revised Cardiac Risk Index maintained a similar discriminative capacity after THA, researchers found it was not a significant predictor of postoperative cardiac events after TKA. – by Casey Tingle
Disclosures: Waterman receives royalties, financial or material support from Elsevier; is on the editorial board of Arthroscopy Journal; is on the communications and research committees for Society of Military Orthopaedic Surgeons; and is on the fellowship committee and online CME task force for the Arthroscopy Association of North America. Please see the full study for a list of all other researchers’ relevant financial disclosures.
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