Risk factors and postoperative complications following revision total knee arthroplasty in patients with metabolic syndrome–associated osteoarthritis: a 10-year retrospective analysis using a national inpatient database - Summary - MDSpire
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Postoperative Outcomes and Risk Factors in Revision Total Knee Arthroplasty for Patients with Osteoarthritis Linked to Metabolic Syndrome: A Decade-Long Retrospective Study Utilizing a National Inpatient Database
To examine temporal trends in metabolic syndrome–associated osteoarthritis (MetS-OA) among patients undergoing revision total knee arthroplasty (RTKA) and to identify patient- and clinical-level factors associated with this condition and related outcomes.
Approach:
Study Design: Retrospective cohort analysis using data from the Nationwide Inpatient Sample from 2010 to 2019.
Data Analysis: Assessment of patient demographics, hospital characteristics, length of stay, total hospitalization charges, in-hospital mortality, comorbid conditions, and perioperative complications using multivariable logistic regression models.
Key Findings:
The overall prevalence of MetS-OA among RTKA hospitalizations was 16.1%, increasing from 2011 to 2019.
Factors independently associated with MetS-OA included advanced age, male sex, non-White racial background, and comorbid conditions such as chronic pulmonary disease, depression, and hypothyroidism.
Patients with MetS-OA had longer hospital stays and higher median total hospitalization charges, exceeding those without MetS-OA by $1,445.50.
In-hospital mortality rates did not differ significantly between MetS-OA and non-MetS-OA groups.
MetS-OA was linked to a higher likelihood of postoperative complications, including acute myocardial infarction, severe malnutrition, acute cerebrovascular disease, postoperative delirium, acute respiratory distress syndrome, prolonged mechanical ventilation, urinary tract infections, acute renal failure, and lower limb nerve injury.
Interpretation:
The prevalence of MetS-OA among patients undergoing RTKA has increased over time and is associated with a higher burden of postoperative complications and healthcare utilization.
Limitations:
The study is based on retrospective data, which may limit causal inferences.
Data may be subject to coding inaccuracies inherent in administrative databases.
Conclusion:
Targeted preoperative optimization and standardized perioperative management strategies for patients with MetS-OA may mitigate adverse events and enhance postoperative recovery.
