Chronic Kidney Disease Impact on Total Joint Arthroplasty Outcomes: A National Inpatient Sample Based Study

2020 ◽  
Vol 34 (S1) ◽  
pp. 1-1
Author(s):  
Allyson N DiMagno ◽  
Inaya Hajj Hussein ◽  
Zain Sayeed ◽  
Mouhanad M El-Othmani
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
National Inpatient Sample ◽  
Disease Impact

scholarly journals Chronic kidney disease impact on total joint arthroplasty outcomes: A National Inpatient Sample-based study

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902091612
Author(s):  
Allyson N DiMagno ◽  
Inaya Hajj-Hussein ◽  
Amjad El Othmani ◽  
Jordan Stasch ◽  
Zain Sayeed ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Stage I ◽  
Stage Iii ◽  
Total Charge ◽  
National Inpatient Sample ◽  
Group I ◽  
Ckd Stage

Introduction: In the United States, chronic kidney disease (CKD) affects roughly 11% of the population or 19.2 million people. As the prevalence of CKD and demand for total joint arthroplasty (TJA) continue to rise, it is critical to assess the impact of CKD on postoperative clinical and economic outcomes. Methods: Discharge data from 2006 to 2011 National Inpatient Sample were used for this study. A total of 851,150 TJA patients were divided into three cohorts: group 1 included no CKD, CKD stage I, and CKD stage II; group 2 included CKD stage III and stage IV; group 3 included CKD stage V. Inverse probability of treatment weighting/propensity score weighting was used to predict outcome variables as a function of age, sex, and Elixhauser comorbidities. Patients were compared against group I for in-hospital postoperative outcomes. Results: Stage III/IV CKD patients undergoing primary TJA had higher odds of any complication (odds ratio (OR), 2.63; p < 0.0001), longer length of stay (LOS), and higher total charge (LOS, 4.34 vs. 3.48 days; total charge, US$56,003 vs. US$46,115; p < 0.0001) when compared to patients with no CKD/stage I or II. Similarly, stage V CKD patients undergoing primary TJA had higher odds of any complication (OR, 1.64; p < 0.0001), longer LOS, and higher total charges (LOS, 5.81 vs. 3.48 days; total charge, US$59,869 vs. US$46,115) than their counterparts with no CKD/stage I or II CKD. Discussion: Our results indicate that stage III, IV, or V CKD, compared with those with no CKD, stage I or II patients are at a greater risk for postoperative complications and consume more resources following TJA.

Acute Kidney Injury in Subjects With Chronic Kidney Disease Undergoing Total Joint Arthroplasty

2019 ◽  
Vol 358 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Karim M. Soliman ◽  
Ruth C. Campbell ◽  
Tibor Fülöp ◽  
Tomoko Goddard ◽  
Roberto Pisoni
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Total Joint Arthroplasty ◽  
Kidney Injury ◽  
Joint Arthroplasty

Chronic Kidney Disease Linearly Predicts Outcomes After Elective Total Joint Arthroplasty

2016 ◽  
Vol 31 (9) ◽  
pp. 175-179.e2 ◽  
Author(s):  
Timothy L. Tan ◽  
Michael M. Kheir ◽  
Dean D. Tan ◽  
Edward J. Filippone ◽  
Eric H. Tischler ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty

Impact of chronic kidney disease on outcomes after total joint arthroplasty: a meta-analysis and systematic review

2019 ◽  
Vol 44 (2) ◽  
pp. 215-229 ◽  
Author(s):  
Jiang Chen ◽  
Fan Zhang ◽  
Chu-Yin Liu ◽  
Qiao-Mei Yuan ◽  
Xue-Shi Di ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Total Joint Arthroplasty ◽  
Meta Analysis ◽  
Joint Arthroplasty

scholarly journals Impact of chronic kidney disease on outcomes after total joint arthroplasty: A meta-analysis & systematic review.

2019 ◽  
Author(s):  
Jiang Chen ◽  
Fan Zhang ◽  
Chu-Yin Liu ◽  
Qiao-Mei Yuan ◽  
Xue-Shi Di ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Total Joint Arthroplasty ◽  
Meta Analysis ◽  
Joint Arthroplasty ◽  
Adverse Outcomes ◽  
Eligibility Criteria ◽  
Manual Search ◽  
Increased Risk ◽  
Ckd Stage

Abstract Background Comorbidities in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) may compromise outcomes with increased hospital stays, readmission and mortality rates. We aimed to determine whether chronic kidney disease (CKD) affects postoperative outcomes of patients undergoing total joint arthroplasty (TJA).Methods To identify studies for this review and meta-analysis, two independent reviewers searched PubMed, Cochrane, EMBASE and Google Scholar until April 1, 2019, and identified additional studies by manual search of reference lists. Prospective or retrospective studies with quantitative outcomes for patients undergoing TJA were selected. Outcomes were compared between patients with underlying CKD stage >=3 or eGFR< 60 mL/min/1.73 m2 versus mild/non-CKD as controls. Main endpoints were mortality, re-operation and re-admission rates.Results Among 59 studies reviewed, 19 meeting the eligibility criteria were included, providing data of 2,141,393 patients. After THA or TKA, CKD was associated with higher mortality risk than non-CKD (pooled OR 2.20, 95%CI = 1.90 to 2.54; P < 0.001); no significant differences were seen in re-operation between CKD and non-CKD patients (pooled OR 1.26, 95%CI = 0.84 to 1.88; P=0.266); and CKD patients had higher any-cause re-admission rates (pooled OR= 1.57, 95%CI = 1.27 to 1.94, P<0.001).Conclusion Underlying CKD predicts adverse outcomes after elective TJA with increased risk of mortality, re-admission, surgical site infection, and perioperative transfusion. Findings of this review and meta-analysis highlight CKD as a critical contributor to complications after TJA and may be helpful to surgeons when advising patients about associated risks of TJA.

scholarly journals Effect of chronic kidney disease on outcomes of total joint arthroplasty: a meta-analysis

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Chang-Wan Kim ◽  
Hyun-Jung Kim ◽  
Chang-Rack Lee ◽  
Lih Wang ◽  
Seung Joon Rhee
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Total Joint Arthroplasty ◽  
Meta Analysis ◽  
Joint Arthroplasty

Abstract 15645: Carotid Artery Stenting and Endarterectomy in Patients With Stage 5 Chronic Kidney Disease: Insights of the Healthcare Cost and Utilization Project’s National Inpatient Sample

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Fabio V Lima ◽  
Tzyy Y Yen ◽  
Luis Gruberg
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Carotid Artery ◽  
Healthcare Cost ◽  
Carotid Artery Stenting ◽  
Hospital Admissions ◽  
Multivariable Analysis ◽  
Hospital Death ◽  
National Inpatient Sample ◽  
Artery Disease

Background: Carotid artery stenting (CAS) has evolved into a viable alternative for the treatment of symptomatic and asymptomatic high-grade carotid artery stenosis, particularly in patients considered to be at a high surgical risk for carotid endarterectomy (CEA). Hypothesis: There is limited data on the outcomes of patients with stage 5 chronic kidney disease (CKD) (GFR<15 mL/min/1.73 m 2 or dialysis) undergoing CEA or CAS. Methods: The Healthcare Cost and Utilization Project’s National Inpatient Sample was screened for hospital admissions of patients undergoing CAS and CEA from 2003-2012. Baseline clinical characteristics and outcomes were identified in patients with stage 5 CKD. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE), defined as the composite of in-hospital death, acute myocardial infarction and acute cerebrovascular accident (CVA). Results: Our study population consisted of 1,723 patients that underwent CEA and 544 patients that underwent CAS. Patients undergoing CAS were younger and had significantly lower rates of coronary artery disease, hypertension and hyperlipidemia. CAS patients experienced significantly higher rates of MACCE compared with patients that underwent CEA, mainly driven by a higher rate of in-hospital strokes (Fig. 1). In a multivariable analysis, CAS (OR 1.53, 95% CI 1.19-1.98) was an independent predictor of MACCE. Conclusions: In patients with stage 5 CKD (GFR<15 mL/min/1.73 m 2 or dialysis ) undergoing internal carotid artery revascularization, CAS was associated with higher rates of in-hospital MACCE, driven by higher mortality and stroke rates when compared with CEA.

P5475Essential thrombocytosis is associated with worse hospital outcomes in patients presented with acute myocardial infarction: a propensity score analysis of the National Inpatient Sample

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Wu ◽  
B Liu ◽  
Y Zheng
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Propensity Score ◽  
Matched Control ◽  
National Inpatient Sample ◽  
Essential Thrombocytosis ◽  
The Impact

Abstract Background/Introduction Essential thrombocytosis (ET) is a rare disease characterized by vasomotor symptom, thrombotic event, and hemorrhage. Due to its rare occurrence, limited data are available to examine the impact of ET on acute myocardial infarction (AMI). Purpose To evaluate the impact of ET on hospital outcomes of AMI. Methods We use the 2016 National Inpatient sample database to identify all the admissions with a principal diagnosis of AMI with or without ET. A matched control group was then generated using propensity score from age, sex, race, location, insurance, income, hospital type, hospital location, Charlsoncat Comorbidity Score. Prevalence, baseline characteristic of AMI patient with or without ET was described and compared. Univariable logistic regression was used to measure mortality and the rate of catheterization. Results ET was found in 0.28% (1,814) in total AMI admissions (641,854). Age (69.52 vs 69.70), female percentage (48.04% vs 48.03%) and baseline comorbidities including STEMI (27.49% vs 25.08%), diabetes (33.03% vs 30.51%), heart failure (40.18 vs 45.89%) and chronic kidney disease (22.05% vs 26.28%) was found to be comparable between two groups (p>0.05, table 1). Compared to non ET group, ET is associated with significantly higher hospital mortality (5.74% vs 2.43%, OR 2.44 [1.09–5.48], p=0.03), prolonged length of stay (7.61 vs 4.30 days, p<0.01). Interestingly, ET is also associated with lower utilization of cardiac catheterization (37.46% vs 46.52%, p=0.01). Essential Thrombocytosis and AMI Parameter AMI with ET Matched control: AMI without ET Odds ratio (95% CI) P value (n=1,814) (n=1,814) Age, years 69.52±0.72 69.70±0.70 p>0.05 Female, % 48.04 48.03 p>0.05 STEMI, % 27.49 25.08 p>0.05 Hypertension, % 81.57 83.08 p>0.05 Diabetes, % 33.03 30.51 p>0.05 Heart failure, % 40.18 45.89 p>0.05 Chronic kidney disease, % 22.05 26.28 p>0.05 Mortality, % 5.74 2.43 2.44 (1.09–5.48) p=0.03 Catheterization, % 37.46 46.52 0.68 (0.51–0.91) P=0.01 Length of stay, days 7.61±0.48 4.30±0.21 P<0.01 Values are reported as mean ± S.E. Categorical variables are represented as frequency. Conclusion ET is infrequently observed in patients with AMI. Having ET is associated with higher hospital mortality, longer hospital stay and lower utilization of cardiac catheterization. Acknowledgement/Funding None

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