Coronary revascularization and adverse events in joint arthroplasty

• Published in: The Journal of surgical research 2015-09, Vol.198 (1), p.135-142
• Main Authors: Tabatabaee, Reza Mostafavi, MD, Rasouli, Mohammad R., MD, Rezapoor, Maryam, MS, Maltenfort, Mitchell G., PhD, Ong, Alvin C., MD, Parvizi, Javad, MD, FRCS
• Format: Article
• Language: English
• Subjects: Adverse events; Aged; Aged, 80 and over; Angioplasty, Balloon, Coronary - adverse effects; Angioplasty, Balloon, Coronary - mortality; Arthroplasty; Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Hip - mortality; Arthroplasty, Replacement, Knee - adverse effects; Arthroplasty, Replacement, Knee - mortality; Coronary angioplasty/stent; Coronary Artery Bypass - adverse effects; Coronary Artery Bypass - mortality; Coronary artery bypass graft; Female; Hospital Mortality; Humans; Male; Middle Aged; Mortality; Nationwide Inpatient Sample; Postoperative Complications - etiology; Surgery; Total joint arthroplasty; Venous Thromboembolism - etiology
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2015.05.013

Abstract Background There is a paucity of literature about outcome of total joint arthroplasty in patients with the history of angioplasty and/or stent or coronary artery bypass graft (CABG). The present study aimed to evaluate perioperative complications and mortality in these patients. Methods We used the Nationwide Inpatient Sample data from 2002–2011. Using the Ninth Revision of the International Classification of Disease, Clinical Modification codes for disorders and procedures, we identified patients with a history of coronary revascularization (angioplasty and/or stent or CABG) and compared the inhospital adverse events in these patients with patients without a history of coronary revascularization. Results Cardiac complications occurred in 1.06% patients with a history of CABG; 0.95% of patients with a coronary angioplasty and/or stent and 0.82% of the control patients. In the multivariate analysis, neither the history of CABG ( P  = 0.07) nor the history of angioplasty and/or stenting ( P  = 0.86) was associated with a higher risk of cardiac complications. However, myocardial infarction occurred in a significantly higher proportion of patients with the history of CABG (0.66%, odds ratio, 1.24, P  = 0.001) and coronary angioplasty and/or stenting (0.67%, odds ratio, 1.96, P