HIGHER RISK OF COMPLICATIONS AFTER TOTAL KNEE ARTHROPLASTY IN OCTOGENARIANS

ABSTRACT Objective: To evaluate the complication rate of total knee arthroplasty (TKA) in octogenarian patients and identify predictive factors. Methods: The study comprised 70 octogenarians and 70 non-octogenarian patients as control group, all submitted to TKA. We analyzed the medical records of these patients, seeking for complications during the first postoperative year. Regarding the risk factors, we evaluated: age, sex, race, American Society of Anesthesiologists score, body mass index, smoking, hypertension and diabetes mellitus. Results: In the control group, the incidence of complications was 7.1%. Whereas in the octogenarian group it was significantly higher, reaching 34.3% (OR 6.8; 95% CI 2.4-19.1). We found no association to sex, skin color, and comorbidities. Age is an independent risk factor for postoperative complications. Our data may help patients to acknowledge the risks of undergoing primary TKA and physicians to assess and adjust perioperative risk. Conclusion: The incidence of postoperative complications is significantly higher in octogenarians. Level of Evidence III, Case-control study.

摘要
研究目的：评估80岁以上老年患者全膝关节置换术（total knee arthroplasty, TKA）的并发症发生率，并明确其相关预测因素。
研究方法：本研究纳入70名80岁以上老年患者，另设70名非老年患者作为对照组，所有受试者均接受初次全膝关节置换术。研究人员回顾分析了所有患者的临床病历，追踪术后1年内发生的各类并发症。针对潜在危险因素，我们评估了年龄、性别、种族、美国麻醉医师协会（American Society of Anesthesiologists, ASA）评分、体重指数、吸烟史、高血压及糖尿病患病情况。
研究结果：对照组并发症发生率为7.1%。而老年组并发症发生率显著更高，达34.3%（优势比OR=6.8；95%置信区间CI：2.4~19.1）。本研究未发现并发症发生率与性别、肤色及合并症存在显著关联。年龄是术后并发症发生的独立危险因素。本研究数据可帮助患者充分了解初次全膝关节置换术的相关风险，同时协助临床医师评估并调整围手术期风险管控策略。
研究结论：80岁以上老年患者术后并发症发生率显著更高。证据等级：Ⅲ级，病例对照研究。