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Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition) ›› 2025, Vol. 11 ›› Issue (01): 4-13. doi: 10.3877/cma.j.issn.2096-0263.2025.01.002

• Arthroplasty • Previous Articles    

Incidence and risk factors of pulmonary complications after revision knee arthroplasty based on USA National Inpatient Sample

Liangxiao Bao1, Zhaofeng Liu1, Hao Xie1, Qinfeng Yang1, Zhanjun Shi1,()   

  1. 1. Department of Orthopaedic Surgery, Division of Orthopaedics, Nanfang Hospital, Southern Medical University,Guangzhou 510515,China
  • Received:2023-11-16 Online:2025-02-05 Published:2025-03-14
  • Contact: Zhanjun Shi

Abstract:

Objective

The aim of this study is to determine the incidence and risk factors of pulmonary complications after revision knee arthroplasty.

Methods

This study conducted a retrospective analysis of patients undergoing revision knee arthroplasty using the National Inpatient Sample Database (NIS) in the United States from 2015 to 2019.This study used Wilcoxon test(continuous data)and Chi square test(categorical data)to analyze patients'demographic indicators,comorbidities,length of stay,total hospitalization expenses,and mortality during hospitalization;And through logistic regression analysis,identify the risk factors leading to pulmonary complications after revision knee arthroplasty.

Results

74 364 patient samples of revision knee arthroplasty were obtained from the NIS database.The total incidence of pulmonary complications after revision knee arthroplasty was 2.69%, and the incidence rate decreased from 2015 to 2016, then slowly in-creased from 2016 to 2019, and generally leveled off. Patients with pulmonary complications after revision knee arthroplasty have a higher number of comorbidities,longer hospital stay,higher hospitalization cost,and mortality during hospitalization.In addition,they use medical insurance more for payment(P<0.001).Risk factors for developing PPC after RKAincluded being treated at a large hospital(OR=1.22,P<0.001),non-emergency/elective admission(OR=0.23,P<0.001),treatment at a teaching hospital(OR=0.23,P<0.001),advanced age(OR=1.20,P<0.001),alcohol abuse(OR=1.64,P<0.001),nutritional anemia(OR=1.26,P<0.001),congestive heart failure(OR=2.51,P<0.001),chronic lung disease(OR=1.78,P<0.001),coagulation disorders(OR=2.25,P<0.001),fluid and electrolyte disorders(OR=4.34,P<0.001),metastatic cancer(OR=2.39,P<0.001),neurological disorders(OR=4.76,P<0.001),obesity(OR=1.50,P<0.001),paralysis(OR=2.10,P<0.001),peripheral vascular disease(OR=1.37,P<0.001),pulmonary circulation disorders(OR=2.61,P<0.001),renal failure(OR=1.21, P<0.001), weight loss (malnutrition) (OR=2.99, P<0.001), deep vein thrombosis (OR=6.09, P<0.001),postoperative delirium(OR=4.84,P<0.001),heart failure(OR=1.19,P<0.001),sepsis(OR=12.91,P<0.001),and wound dehiscence(OR=1.13,P<0.001).

Conclusion

The incidence of pulmonary complications after revision knee arthroplasty is relatively low.Early examination and identification of risk factors related to postoperative pulmonary complications can help make appropriate treatment in advance and mitigate the consequences.

Key words: Knee, Revision knee arthroplasty, Postoperative respiratory complications, Database

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