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dc.contributor.authorMemtsoudis, Stavros G.
dc.contributor.authorMa, Yan
dc.contributor.authorChiu, Ya-Lin
dc.contributor.authorWalz, J. Matthias
dc.contributor.authorVoswinckel, Robert
dc.contributor.authorMazumdar, Madhu
dc.date2022-08-11T08:07:57.000
dc.date.accessioned2022-08-23T15:37:21Z
dc.date.available2022-08-23T15:37:21Z
dc.date.issued2010-11-01
dc.date.submitted2012-08-01
dc.identifier.citationAnesth Analg. 2010 Nov;111(5):1110-6. Epub 2010 Sep 14. <a href="http://dx.doi.org/10.1213/ANE.0b013e3181f43149">Link to article on publisher's site</a>
dc.identifier.issn0003-2999 (Linking)
dc.identifier.doi10.1213/ANE.0b013e3181f43149
dc.identifier.pmid20841415
dc.identifier.urihttp://hdl.handle.net/20.500.14038/25697
dc.description.abstractBACKGROUND: There is a paucity of perioperative outcomes data for patients with chronic pulmonary hypertension (PHTN) undergoing noncardiac surgery. Clinicians, therefore, have little information on which to evaluate the risk for morbidity and mortality in this patient population. In this study, we evaluated the incidence and risks of perioperative morbidity and mortality in patients with PHTN undergoing primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS: Using the largest inpatient database in the United States (National Inpatient Sample), we identified entries for THA and TKA between the years of 1998 and 2006. Patients with the diagnosis of PHTN were identified and matched to those without the disease based on health-related demographic variables. Perioperative mortality was considered the primary outcome. Multivariate logistic regression models were fitted to assess the impact of PHTN on in-hospital mortality. RESULTS: We identified 670,516 entries for TKA and 360,119 for THA. Of those patients, 2184 (0.3%) and 1359 (0.4%), respectively, had the diagnosis of PHTN (average annual rate of 1180 for TKA [range, 507-2073] and 739 for THA [range, 467-1054]). Patients with PHTN undergoing THA experienced an approximately 4-fold increased adjusted risk of mortality (2.4% vs 0.6%), and those undergoing TKA a 4.5-fold increased adjusted risk of mortality (0.9% vs 0.2%) compared with patients without PHTN in the matched sample (P < 0.001 for each comparison). Patients with primary PHTN undergoing THA experienced the highest mortality rate (5% [95% CI, 2.3%-7.7%]). CONCLUSIONS: This analysis demonstrates that patients with PHTN are at increased risk for perioperative mortality after THA and TKA.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=20841415&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1213/ANE.0b013e3181f43149
dc.subjectAdult
dc.subjectAged
dc.subjectArthroplasty, Replacement, Hip
dc.subjectArthroplasty, Replacement, Knee
dc.subjectCase-Control Studies
dc.subjectDatabases as Topic
dc.subjectFemale
dc.subjectHospital Mortality
dc.subjectHumans
dc.subjectHypertension, Pulmonary
dc.subjectLogistic Models
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectOdds Ratio
dc.subjectRisk Assessment
dc.subjectRisk Factors
dc.subjectTime Factors
dc.subjectTreatment Outcome
dc.subjectUnited States
dc.subjectAnesthesiology
dc.subjectOrthopedics
dc.titlePerioperative mortality in patients with pulmonary hypertension undergoing major joint replacement
dc.typeArticle
dc.source.journaltitleAnesthesia and analgesia
dc.source.volume111
dc.source.issue5
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/anesthesiology_pubs/102
dc.identifier.contextkey3168641
html.description.abstract<p>BACKGROUND: There is a paucity of perioperative outcomes data for patients with chronic pulmonary hypertension (PHTN) undergoing noncardiac surgery. Clinicians, therefore, have little information on which to evaluate the risk for morbidity and mortality in this patient population. In this study, we evaluated the incidence and risks of perioperative morbidity and mortality in patients with PHTN undergoing primary total hip arthroplasty (THA) and total knee arthroplasty (TKA).</p> <p>METHODS: Using the largest inpatient database in the United States (National Inpatient Sample), we identified entries for THA and TKA between the years of 1998 and 2006. Patients with the diagnosis of PHTN were identified and matched to those without the disease based on health-related demographic variables. Perioperative mortality was considered the primary outcome. Multivariate logistic regression models were fitted to assess the impact of PHTN on in-hospital mortality.</p> <p>RESULTS: We identified 670,516 entries for TKA and 360,119 for THA. Of those patients, 2184 (0.3%) and 1359 (0.4%), respectively, had the diagnosis of PHTN (average annual rate of 1180 for TKA [range, 507-2073] and 739 for THA [range, 467-1054]). Patients with PHTN undergoing THA experienced an approximately 4-fold increased adjusted risk of mortality (2.4% vs 0.6%), and those undergoing TKA a 4.5-fold increased adjusted risk of mortality (0.9% vs 0.2%) compared with patients without PHTN in the matched sample (P < 0.001 for each comparison). Patients with primary PHTN undergoing THA experienced the highest mortality rate (5% [95% CI, 2.3%-7.7%]).</p> <p>CONCLUSIONS: This analysis demonstrates that patients with PHTN are at increased risk for perioperative mortality after THA and TKA.</p>
dc.identifier.submissionpathanesthesiology_pubs/102
dc.contributor.departmentDepartment of Anesthesiology
dc.source.pages1110-6


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