Abstract
This study aimed to analyze the rates and risk factors of postoperative mortality among 560,954 patients who underwent total knee arthroplasty (TKA) in Korea. The National Health Insurance Service-Health Screening database was used to analyze 560,954 patients who underwent TKA between 2005 and 2018. In-hospital, ninety-day, and one-year postoperative mortality, and their association with patient’s demographic factors and various comorbidities (ie., cerebrovascular disease, congestive heart failure, and myocardial infarction) were assessed. In-hospital, ninety-day and one-year mortality rates after TKA were similar from 2005 to 2018. The risk of in-hospital mortality increased with comorbidities like cerebrovascular disease (hazard ratio [HR] = 1.401; 95% confidence interval [CI] = 1.064–1.844), congestive heart failure (HR = 2.004; 95% CI = 1.394 to 2.881), myocardial infarction (HR = 2.111; 95% CI = 1.115 to 3.998), and renal disease (HR = 2.641; 95% CI = 1.348–5.173). These co-morbidities were also independent predictors of ninety-day and one-year mortality. Male sex and old age were independent predictors for ninety-day and one-year mortality. And malignancy was risk factor for one-year mortality. The common preoperative risk factors for mortality in all periods were male sex, old age, cerebrovascular disease, congestive heart failure, myocardial infarction, and renal disease. Malignancy was identified as risk factor for one-year mortality. Patients with these comorbidities should be provided better perioperative care.
Highlights
Total Knee Arthroplasty (TKA) is performed in the advanced stage of osteoarthritis
More than 700,000 cases of total knee arthroplasty (TKA) are performed per year in the United States, and it is estimated that the number will increase to 3.5 million cases by 20302,3,8–11
The in-hospital mortality rate after TKA from 2005 to 2018 remained unchanged at 0.04%, and the ninety-day were similar from 0.17% to 0.15% and one-year mortality rates were similar from 0.78 to 0.54% (Table 1)
Summary
Total Knee Arthroplasty (TKA) is performed in the advanced stage of osteoarthritis. It is a cost-effective treatment that has successful outcomes, which reduce pain and improve the quality of life for patients with advanced knee osteoarthritis[1,2,3,4]. Obesity is known to be a major risk factor for knee a rthritis[5,6]; this is a reason for the increase in number of patients undergoing TKA. More than 700,000 cases of TKA are performed per year in the United States, and it is estimated that the number will increase to 3.5 million cases by 20302,3,8–11. We aimed to analyze the incidence and risk factors for mortality after TKA in Korea through a large nationwide data research
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