Preoperative Dehydration Is an Underrecognized Modifiable Risk Factor in Total Hip Arthroplasty.

Brandon E Lung, Matthew Kim, Kylie Callan, Maddison McLellan, Edward D Wang, William McMaster, Steven Yang, David H So
{"title":"Preoperative Dehydration Is an Underrecognized Modifiable Risk Factor in Total Hip Arthroplasty.","authors":"Brandon E Lung, Matthew Kim, Kylie Callan, Maddison McLellan, Edward D Wang, William McMaster, Steven Yang, David H So","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>Dehydration is an overlooked modifiable risk factor that should be optimized prior to elective total hip arthroplasty (THA) to reduce postoperative complications and inpatient costs. All primary THA from 2005 - 2019 were queried from the National Surgical Quality Improvement Program database, and patients were compared based on dehydration status: blood urea nitrogen (BUN): creatinine ratio (Cr) (BUN/Cr) < 20 (nondehydrated), 20 ≤ BUN/Cr ≤ 25 (moderately dehydrated), 25 < BUN/Cr (severely dehydrated). A subgroup analysis involving only elderly patients > 65 years and normalized gender-adjusted Cr values was also performed. The analysis included 212,452 patients who underwent THA. Adjusted multivariate logistic regression analysis showed that the severely dehydrated cohort had a greater risk of overall complications, postoperative anemia requiring transfusion, nonhome discharge, and increased length of stay (all p < 0.01). Among the elderly, dehydrated patients had a greater risk of postoperative transfusion, cardiac complications, and nonhome discharge (all p < 0.01). BUN/Cr > 20 is an important preoperative diagnostic tool to identify at-risk dehydrated patients. Providers should optimize dehydration to prevent complications, decrease costs, and improve discharge planning. (Journal of Surgical Orthopaedic Advances 33(1):017-025, 2024).</p>","PeriodicalId":516534,"journal":{"name":"Journal of surgical orthopaedic advances","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of surgical orthopaedic advances","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Dehydration is an overlooked modifiable risk factor that should be optimized prior to elective total hip arthroplasty (THA) to reduce postoperative complications and inpatient costs. All primary THA from 2005 - 2019 were queried from the National Surgical Quality Improvement Program database, and patients were compared based on dehydration status: blood urea nitrogen (BUN): creatinine ratio (Cr) (BUN/Cr) < 20 (nondehydrated), 20 ≤ BUN/Cr ≤ 25 (moderately dehydrated), 25 < BUN/Cr (severely dehydrated). A subgroup analysis involving only elderly patients > 65 years and normalized gender-adjusted Cr values was also performed. The analysis included 212,452 patients who underwent THA. Adjusted multivariate logistic regression analysis showed that the severely dehydrated cohort had a greater risk of overall complications, postoperative anemia requiring transfusion, nonhome discharge, and increased length of stay (all p < 0.01). Among the elderly, dehydrated patients had a greater risk of postoperative transfusion, cardiac complications, and nonhome discharge (all p < 0.01). BUN/Cr > 20 is an important preoperative diagnostic tool to identify at-risk dehydrated patients. Providers should optimize dehydration to prevent complications, decrease costs, and improve discharge planning. (Journal of Surgical Orthopaedic Advances 33(1):017-025, 2024).

术前脱水是全髋关节置换术中一个未被充分认识的可调整风险因素。
脱水是一个被忽视的可改变的风险因素,应在择期全髋关节置换术(THA)前对其进行优化,以减少术后并发症和住院费用。我们从国家外科质量改进计划数据库中查询了 2005 - 2019 年间的所有初级全髋关节置换术,并根据脱水状态对患者进行了比较:血尿素氮(BUN):肌酐比值(Cr)(BUN/Cr)< 20(未脱水),20 ≤ BUN/Cr ≤ 25(中度脱水),25 < BUN/Cr(严重脱水)。此外,还进行了一项亚组分析,仅涉及年龄大于 65 岁的老年患者和经过性别调整的正常化 Cr 值。该分析包括 212,452 名接受 THA 的患者。调整后的多变量逻辑回归分析表明,严重脱水的组群发生总体并发症、术后贫血需要输血、不能回家出院和住院时间延长的风险更高(所有数据均小于 0.01)。在老年患者中,脱水患者出现术后输血、心脏并发症和非居家出院的风险更高(均为 P <0.01)。BUN/Cr > 20 是识别高危脱水患者的重要术前诊断工具。医疗人员应优化脱水情况,以预防并发症、降低成本并改善出院计划。(外科骨科进展杂志》33(1):017-025,2024 年)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信