Elsiwy Yassin, Jovanovic Ivana, Doma Kenji, Hazratwala Kaushik, Letson Hayley
Orthopaedic Research Institute of Queensland, Townsville, QLD, Australia.
College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.
J Orthop Surg Res. 2019 Jan 11;14(1):15. doi: 10.1186/s13018-018-1058-9.
Cardiac complication represents a major cause of morbidity and mortality after total joint arthroplasty, thus necessitating investigation into the associated risks in total hip arthroplasty and total knee arthroplasty. There remains a lack of clarity for many risk factors in the current literature. The aim of this systematic review is to assess the most recent published literature and identify the risk factors associated with cardiac complication in total hip arthroplasty and total knee arthroplasty.
Scopus, PubMed, CINHAL, and Cochrane were searched to identify studies published since 2008 reporting on risk factors associated with cardiac complication in elective primary in total hip arthroplasty and total knee arthroplasty in patients ≥18 years old with osteoarthritis. Reported odds ratios, hazard ratios, and relative risk were the principal summary measures collected. The included studies were too heterogeneous to enable meta-analysis.
Fifteen studies were included in this systematic review. Increasing age and history of cardiac disease were found by most studies to be positively associated with risk of cardiac complication. There was no strong association found between obesity and cardiac complication. The evidence for other risk factors was less clear in the examined literature, although there is suggestive evidence for male gender and cerebrovascular disease increasing risk.
Increasing age and history of cardiac disease increases the risk of cardiac complication after total hip arthroplasty and total knee arthroplasty. Other risk factors commonly attributed to increased risk in non-cardiac surgery including hypertension and obesity require further evaluation in arthroplasty.
A detailed protocol was published in the PROSPERO database (registration number CRD42018095887 ) for this systematic review.
心脏并发症是全关节置换术后发病和死亡的主要原因，因此有必要对全髋关节置换术和全膝关节置换术的相关风险进行调查。目前文献中许多风险因素仍不明确。本系统评价的目的是评估最新发表的文献，确定全髋关节置换术和全膝关节置换术中与心脏并发症相关的风险因素。
检索Scopus、PubMed、CINHAL和Cochrane数据库，以识别自2008年以来发表的关于≥18岁骨关节炎患者择期初次全髋关节置换术和全膝关节置换术中与心脏并发症相关风险因素的研究。收集报道的比值比、风险比和相对风险作为主要汇总指标。纳入的研究异质性太大，无法进行荟萃分析。
本系统评价纳入了15项研究。大多数研究发现，年龄增长和心脏病史与心脏并发症风险呈正相关。未发现肥胖与心脏并发症之间有强关联。在所审查的文献中，其他风险因素的证据不太明确，尽管有提示性证据表明男性和脑血管疾病会增加风险。
年龄增长和心脏病史会增加全髋关节置换术和全膝关节置换术后心脏并发症的风险。其他通常被认为会增加非心脏手术风险的风险因素，如高血压和肥胖，在关节置换术中需要进一步评估。
本系统评价在PROSPERO数据库（注册号CRD42018095887）中发表了详细方案。
