Patients with hypertension are at increased risk for death, complications after TKA
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Patients with pulmonary hypertension who undergo primary or revision total knee arthroplasty have increased mortality and complications within 90 days of surgery, according to published results.
Courtney E. Baker, MD, and colleagues from the Mayo Clinic, Rochester retrospectively analyzed data on 887 patients with pulmonary hypertension (HTN) who underwent 881 primary TKAs and 228 revision TKAs from 2000 to 2016. Outcome measures included perioperative and 90-day postoperative medical complications and risk of death, which was calculated using mortality ratios and Cox proportional hazards regression models, according to the study.
Baker and colleagues found risk of death was twofold higher in patients undergoing TKA with pulmonary HTN compared with those without pulmonary HTN. 90-day mortality was 0.68% (n = 6) in primary TKAs and 4.82% (n = 11) in revision TKAs. Researchers also noted a “high incidence of total medical complications” – including death – at 6.47% in the primary TKA group and 14.04% in the revision TKA group. The most common perioperative complications included cardiac arrhythmia (2.43%, n = 27), deep vein thrombosis (0.90%, n = 10) and respiratory failure (0.81%, n = 9).
“This highlights the need for appropriate counseling, medical optimization, and likely referral to tertiary care centers with additional available resources for TKA in this medically complex patient population,” the researchers wrote in the study.
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