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Chronic Obstructive Pulmonary Disease Is Associated With Short-Term Complications Following Total Hip Arthroplasty.
J Arthroplasty 2018; 33(6):1926-1929JA

Abstract

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. Furthermore, COPD patients are at increased risk of complications following surgery. The purpose of this study was to evaluate the postoperative total hip arthroplasty (THA) outcomes of COPD patients. Specifically, we asked the following questions: (1) Is COPD associated with adverse perioperative outcomes and (2) Does COPD increase the risk of short-term complications following THA?

METHODS

The American College of Surgeons National Surgical Quality Improvement Program database was used to identify 64,796 patients who underwent THA between 2008 and 2014. A total of 2426 patients with COPD were identified. COPD and non-COPD cohorts were compared based on the following outcomes: hospital length-of-stay, operative times, discharge disposition, and 30-day postoperative complications.

RESULTS

COPD patients were found to have a longer length-of-stay and be discharged to an extended care facility (P < .001). COPD patients were also at significantly (P < .05) increased risk for any complication, such as mortality, myocardial infarction, pneumonia, septic shock, unplanned reintubation, use of a mechanical ventilator >48 hours, deep infection, require a blood transfusion, return to operating room, and a readmission within 30 days postoperatively.

CONCLUSIONS

COPD patients are more likely to suffer from postoperative complications following THA when compared to non-COPD patients. Many of these complications are medical, pulmonary evaluation and medical optimization are a critical step in preoperative management for these patients.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, Florida.Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29402713

Citation

Yakubek, George A., et al. "Chronic Obstructive Pulmonary Disease Is Associated With Short-Term Complications Following Total Hip Arthroplasty." The Journal of Arthroplasty, vol. 33, no. 6, 2018, pp. 1926-1929.
Yakubek GA, Curtis GL, Sodhi N, et al. Chronic Obstructive Pulmonary Disease Is Associated With Short-Term Complications Following Total Hip Arthroplasty. J Arthroplasty. 2018;33(6):1926-1929.
Yakubek, G. A., Curtis, G. L., Sodhi, N., Faour, M., Klika, A. K., Mont, M. A., ... Higuera, C. A. (2018). Chronic Obstructive Pulmonary Disease Is Associated With Short-Term Complications Following Total Hip Arthroplasty. The Journal of Arthroplasty, 33(6), pp. 1926-1929. doi:10.1016/j.arth.2017.12.043.
Yakubek GA, et al. Chronic Obstructive Pulmonary Disease Is Associated With Short-Term Complications Following Total Hip Arthroplasty. J Arthroplasty. 2018;33(6):1926-1929. PubMed PMID: 29402713.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic Obstructive Pulmonary Disease Is Associated With Short-Term Complications Following Total Hip Arthroplasty. AU - Yakubek,George A, AU - Curtis,Gannon L, AU - Sodhi,Nipun, AU - Faour,Mhamad, AU - Klika,Alison K, AU - Mont,Michael A, AU - Barsoum,Wael K, AU - Higuera,Carlos A, Y1 - 2018/01/09/ PY - 2017/12/05/received PY - 2017/12/19/revised PY - 2017/12/30/accepted PY - 2018/2/7/pubmed PY - 2019/3/5/medline PY - 2018/2/7/entrez KW - chronic obstructive pulmonary disease KW - complications KW - discharge disposition KW - lengths-of-stay KW - readmission KW - total hip arthroplasty SP - 1926 EP - 1929 JF - The Journal of arthroplasty JO - J Arthroplasty VL - 33 IS - 6 N2 - BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. Furthermore, COPD patients are at increased risk of complications following surgery. The purpose of this study was to evaluate the postoperative total hip arthroplasty (THA) outcomes of COPD patients. Specifically, we asked the following questions: (1) Is COPD associated with adverse perioperative outcomes and (2) Does COPD increase the risk of short-term complications following THA? METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify 64,796 patients who underwent THA between 2008 and 2014. A total of 2426 patients with COPD were identified. COPD and non-COPD cohorts were compared based on the following outcomes: hospital length-of-stay, operative times, discharge disposition, and 30-day postoperative complications. RESULTS: COPD patients were found to have a longer length-of-stay and be discharged to an extended care facility (P < .001). COPD patients were also at significantly (P < .05) increased risk for any complication, such as mortality, myocardial infarction, pneumonia, septic shock, unplanned reintubation, use of a mechanical ventilator >48 hours, deep infection, require a blood transfusion, return to operating room, and a readmission within 30 days postoperatively. CONCLUSIONS: COPD patients are more likely to suffer from postoperative complications following THA when compared to non-COPD patients. Many of these complications are medical, pulmonary evaluation and medical optimization are a critical step in preoperative management for these patients. SN - 1532-8406 UR - https://www.unboundmedicine.com/medline/citation/29402713/Chronic_Obstructive_Pulmonary_Disease_Is_Associated_With_Short_Term_Complications_Following_Total_Hip_Arthroplasty_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0883-5403(18)30005-6 DB - PRIME DP - Unbound Medicine ER -