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Comparing Inpatient Complication Rates between Octogenarians and Nonagenarians following Primary and Revision Total Knee Arthroplasty in a Nationally Representative Sample, 2010–2014

1
Boston Medical Center, Department of Orthopaedic Surgery, Boston, MA 02118, USA
2
Boston University School of Medicine, Boston, MA 02118, USA
3
Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
*
Author to whom correspondence should be addressed.
Geriatrics 2019, 4(1), 3; https://doi.org/10.3390/geriatrics4010003
Received: 11 October 2018 / Revised: 10 December 2018 / Accepted: 18 December 2018 / Published: 22 December 2018
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Abstract

We compared the inpatient postoperative complication rates between octogenarians and nonagenarians undergoing primary and revision total knee arthroplasty (TKA). We used the Nationwide Inpatient Sample (NIS) to analyze inpatient admission data from 2010–2014. We compared the rates at which nonagenarians and octogenarians developed each complication following both primary TKA (PTKA) and revision TKA (RTKA). A national estimate of 324,933 patients were included in our study. A total of 313,299 (96.42%) were octogenarians, and 11,634 (3.58%) were nonagenarians. 294,462 (90.62%) underwent PTKA, and 30,471 (9.38%) underwent RTKA. Nonagenarians undergoing PTKA had a higher inpatient mortality rate, and developed sepsis more frequently than octogenarians. Nonagenarians undergoing RTKA had a higher inpatient mortality rate, and developed cardiogenic shock more frequently than octogenarians. In both PTKA and RTKA, nonagenarians received transfusions more frequently, and developed urinary tract infection and acute kidney injury more frequently than octogenarians. In both PTKA and RTKA, nonagenarians sustained a higher inpatient mortality rate than octogenarians. Orthopedic surgeons should counsel nonagenarian patients undergoing both PTKA and RTKA preoperatively about this increased mortality risk, as well as the increased risks of more minor complications like transfusion, urinary tract infection, and acute kidney injury. View Full-Text
Keywords: total knee arthroplasty; total knee revision arthroplasty; arthroplasty in octogenarians; arthroplasty in nonagenarians; primary total knee arthroplasty complications; revision total knee arthroplasty complications total knee arthroplasty; total knee revision arthroplasty; arthroplasty in octogenarians; arthroplasty in nonagenarians; primary total knee arthroplasty complications; revision total knee arthroplasty complications
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Smith, E.L.; Dugdale, E.M.; Tybor, D.; Kain, M. Comparing Inpatient Complication Rates between Octogenarians and Nonagenarians following Primary and Revision Total Knee Arthroplasty in a Nationally Representative Sample, 2010–2014. Geriatrics 2019, 4, 3.

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