Postoperative delirium is a risk factor for complications and poor outcome after total hip and knee arthroplasty

Background and purpose — Improving health care and demographic change have resulted in a steady increase in geriatric patients undergoing total hip (THA) and knee (TKA) arthroplasty. Postoperative delirium (POD) is a frequent and severe complication after major surgery. Therefore, we analyzed the im...

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Autores principales:	Matthias Meyer, Julia Götz, Lukas Parik, Tobias Renkawitz, Joachim Grifka, Günther Maderbacher, Tobias Kappenschneider, Markus Weber
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2021
Materias:	Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/efb5b372f3b3440f85e00dfccfc280b2
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spelling	oai:doaj.org-article:efb5b372f3b3440f85e00dfccfc280b22021-11-26T11:19:48ZPostoperative delirium is a risk factor for complications and poor outcome after total hip and knee arthroplasty1745-36741745-368210.1080/17453674.2021.1980676https://doaj.org/article/efb5b372f3b3440f85e00dfccfc280b22021-10-01T00:00:00Zhttp://dx.doi.org/10.1080/17453674.2021.1980676https://doaj.org/toc/1745-3674https://doaj.org/toc/1745-3682Background and purpose — Improving health care and demographic change have resulted in a steady increase in geriatric patients undergoing total hip (THA) and knee (TKA) arthroplasty. Postoperative delirium (POD) is a frequent and severe complication after major surgery. Therefore, we analyzed the impact of POD on outcome after THA and TKA. Patients and methods — In a consecutive series of 10,140 patients who had undergone elective THA or TKA between 2011 and 2020, rates of reoperation within 90 days, readmission within 90 days, complications, and responder rate as defined by the OMERACT-OARSI criteria were compared between patients with and without POD. Multivariable logistic regression models were used to assess the relationship between POD and other postoperative complications. Results — Patients with POD showed higher rates of reoperation (12% vs. 5%), readmission (15% vs. 5%), surgical complications (7% vs. 2%), non-surgical complications (8% vs. 4%), Clavien–Dindo IV° complications (10% vs. 2%) and transfusion (14% vs. 2%). POD led to lower responder rate (76% vs. 87%) 1 year after total joint replacement. All previous comparisons statistically significant. Multivariable logistic regression analyses revealed POD as an independent risk factor for reoperation (OR = 2; CI 1–3), readmission (OR = 2; CI 2–4) and Clavien–Dindo IV° complications (OR = 3; CI 2–5). Interpretation — POD is a serious problem in elective joint replacement. Affected patients suffer more complications and show poor patient-reported outcome 1 year postoperatively. Systematic prevention strategies and standardized therapy protocols are mandatory to avoid burden to patients and healthcare providers.Matthias MeyerJulia GötzLukas ParikTobias RenkawitzJoachim GrifkaGünther MaderbacherTobias KappenschneiderMarkus WeberTaylor & Francis GrouparticleOrthopedic surgeryRD701-811ENActa Orthopaedica, Vol 92, Iss 6, Pp 695-700 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Orthopedic surgery RD701-811
spellingShingle	Orthopedic surgery RD701-811 Matthias Meyer Julia Götz Lukas Parik Tobias Renkawitz Joachim Grifka Günther Maderbacher Tobias Kappenschneider Markus Weber Postoperative delirium is a risk factor for complications and poor outcome after total hip and knee arthroplasty
description	Background and purpose — Improving health care and demographic change have resulted in a steady increase in geriatric patients undergoing total hip (THA) and knee (TKA) arthroplasty. Postoperative delirium (POD) is a frequent and severe complication after major surgery. Therefore, we analyzed the impact of POD on outcome after THA and TKA. Patients and methods — In a consecutive series of 10,140 patients who had undergone elective THA or TKA between 2011 and 2020, rates of reoperation within 90 days, readmission within 90 days, complications, and responder rate as defined by the OMERACT-OARSI criteria were compared between patients with and without POD. Multivariable logistic regression models were used to assess the relationship between POD and other postoperative complications. Results — Patients with POD showed higher rates of reoperation (12% vs. 5%), readmission (15% vs. 5%), surgical complications (7% vs. 2%), non-surgical complications (8% vs. 4%), Clavien–Dindo IV° complications (10% vs. 2%) and transfusion (14% vs. 2%). POD led to lower responder rate (76% vs. 87%) 1 year after total joint replacement. All previous comparisons statistically significant. Multivariable logistic regression analyses revealed POD as an independent risk factor for reoperation (OR = 2; CI 1–3), readmission (OR = 2; CI 2–4) and Clavien–Dindo IV° complications (OR = 3; CI 2–5). Interpretation — POD is a serious problem in elective joint replacement. Affected patients suffer more complications and show poor patient-reported outcome 1 year postoperatively. Systematic prevention strategies and standardized therapy protocols are mandatory to avoid burden to patients and healthcare providers.
format	article
author	Matthias Meyer Julia Götz Lukas Parik Tobias Renkawitz Joachim Grifka Günther Maderbacher Tobias Kappenschneider Markus Weber
author_facet	Matthias Meyer Julia Götz Lukas Parik Tobias Renkawitz Joachim Grifka Günther Maderbacher Tobias Kappenschneider Markus Weber
author_sort	Matthias Meyer
title	Postoperative delirium is a risk factor for complications and poor outcome after total hip and knee arthroplasty
title_short	Postoperative delirium is a risk factor for complications and poor outcome after total hip and knee arthroplasty
title_full	Postoperative delirium is a risk factor for complications and poor outcome after total hip and knee arthroplasty
title_fullStr	Postoperative delirium is a risk factor for complications and poor outcome after total hip and knee arthroplasty
title_full_unstemmed	Postoperative delirium is a risk factor for complications and poor outcome after total hip and knee arthroplasty
title_sort	postoperative delirium is a risk factor for complications and poor outcome after total hip and knee arthroplasty
publisher	Taylor & Francis Group
publishDate	2021
url	https://doaj.org/article/efb5b372f3b3440f85e00dfccfc280b2
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Postoperative delirium is a risk factor for complications and poor outcome after total hip and knee arthroplasty

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