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Increased risk of complications after total joint replacement seen in patients with schizophrenia
In a study published in The Journal of Arthroplasty, J. Joseph Gholson, MD, and colleagues found patients with schizophrenia who underwent total joint arthroplasty had an increased risk of all-cause medical and surgical complications.
Investigators used the nationwide inpatient sample to identify 505,840 patients who had total joint arthroplasty between 2009 and 2012. From this sample, 953 (0.2%) of patients with schizophrenia were identified using ICD-9 codes. Individual and collective medical and surgical complications at the time of surgery, length of stay and discharge rates were considered. A multivariate logistic regression was used to determine the impact of schizophrenia on short-term surgical outcomes.
Compared with patients who did not have schizophrenia, patients with the condition were 15-times more likely to have increased pulmonary insufficiency and were 11-times more likely to have mental status changes. In addition, patients with schizophrenia were three-times more likely to have mechanical implant complications and were twice as likely to require a transfusion. Although schizophrenia is a relatively uncommon comorbidity, the authors recommend including the high risks associated with schizophrenia in future risk-adjustment models for total joint arthroplasty. – by Karen Keeney
Disclosures: Gholson reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.