Risk factors associated with cardiac complication after total joint arthroplasty of the hip and knee: a systematic review

Elsiwy, Yassin, Jovanovic, Ivana, Doma, Kenji, Hazratwala, Kaushik, and Letson, Hayley (2019) Risk factors associated with cardiac complication after total joint arthroplasty of the hip and knee: a systematic review. Journal of Orthopaedic Surgery and Research, 14. 15.

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Abstract

Background: Cardiac complication represents a major cause of morbidity and mortality after total joint arthroplasty, thus necessitating investigation into the associated risks in total hip arthroplasty and total knee arthroplasty. There remains a lack of clarity for many risk factors in the current literature. The aim of this systematic review is to assess the most recent published literature and identify the risk factors associated with cardiac complication in total hip arthroplasty and total knee arthroplasty.

Methods: Scopus, PubMed, CINHAL, and Cochrane were searched to identify studies published since 2008 reporting on risk factors associated with cardiac complication in elective primary in total hip arthroplasty and total knee arthroplasty in patients 18years old with osteoarthritis. Reported odds ratios, hazard ratios, and relative risk were the principal summary measures collected. The included studies were too heterogeneous to enable meta-analysis.

Results: Fifteen studies were included in this systematic review. Increasing age and history of cardiac disease were found by most studies to be positively associated with risk of cardiac complication. There was no strong association found between obesity and cardiac complication. The evidence for other risk factors was less clear in the examined literature, although there is suggestive evidence for male gender and cerebrovascular disease increasing risk.

Conclusions: Increasing age and history of cardiac disease increases the risk of cardiac complication after total hip arthroplasty and total knee arthroplasty. Other risk factors commonly attributed to increased risk in non-cardiac surgery including hypertension and obesity require further evaluation in arthroplasty.

Systematic review registration: A detailed protocol was published in the PROSPERO database (registration number CRD42018095887) for this systematic review.

Item ID: 57019
Item Type: Article (Research - C1)
ISSN: 1749-799X
Keywords: cardiac, arthroplasty, TKA, THA, risk factor, complication
Copyright Information: © The Author(s). 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License.
Date Deposited: 06 Feb 2019 07:33
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1102 Cardiovascular Medicine and Haematology > 110201 Cardiology (incl Cardiovascular Diseases) @ 50%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110314 Orthopaedics @ 50%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 50%
92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920116 Skeletal System and Disorders (incl. Arthritis) @ 50%
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