Massaglia J, Yayac M, Star A, Deirmengian G, Courtney PM, Saxena A. Gastrointestinal Complications Following Total Joint Arthroplasty Are Rare but Have Severe Consequences.
J Arthroplasty 2021;
36:2974-2979. [PMID:
33824046 DOI:
10.1016/j.arth.2021.03.005]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/17/2021] [Accepted: 03/01/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND
Gastrointestinal (GI) complications following total joint arthroplasty (TJA) are rare, but can result in substantial morbidity and mortality, especially when intervention is required. The purpose of this study is to identify modifiable risk factors for the development of GI complications and determine their impact on short-term outcomes following TJA.
METHODS
We queried patients who underwent primary TJA at a single academic center from 2009 through 2018 and collected data on demographics, comorbidities, operative and perioperative details, and short-term outcomes. Patients who suffered at least one GI complication during the same hospitalization as their TJA were identified. The type of GI complication and intervention performed, if necessary, was recorded. Variables that independently affected the risk of GI complication were identified. Multivariate regression was performed to determine the effect suffering a GI complication had on outcomes.
RESULTS
Of 17,402 patients, 106 (0.6%) suffered a GI complication. Constipation/obstruction, followed by diarrhea/malabsorption, hemorrhage, and Clostridium difficile were the most commonly reported complications. Patients suffering a GI complication were significantly older (68.5 vs 63.7, P < .001), less likely to use alcohol (49% vs 65%, P = .008), and had higher incidences of 8 of the 16 comorbidities analyzed (all P < .05). Patients with GI complications had greater lengths of stay (13.2 vs 2.3 days, P < .001), discharge to facility rates (58% vs 16%, P < .001), and in-hospital mortality rates (1.9% vs 0.1%, P = .002).
CONCLUSION
Patients suffering a GI complication following TJA require longer hospital stays and greater post-acute care resources and have a substantially higher risk of mortality.
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