{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T18:10:22Z","timestamp":1730916622523,"version":"3.28.0"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"14","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Total knee arthroplasty (TKA) is the most common joint arthroplasty procedure and is shown to be a reliable and efficacious way to improve quality of life. Individuals with interatrial wall abnormalities (IAWAs), such as atrial septal defect or patent foramen ovale (PFO), are at increased baseline risk for stroke and overall lifetime morbidity. The purpose of our study was to elucidate the association between IAWAs and perioperative TKA outcomes.<\/jats:p><jats:p>We performed a retrospective cohort study utilizing the Healthcare Cost and Utilization Project National Inpatient Sample database. Admissions for TKA between 2010 and 2019 were identified using the international classification of disease (ICD)-9 and ICD-10 procedure codes. Patients with ICD-9-clinical modification (CM) diagnosis code 7455 or ICD-10-CM diagnosis code Q211 were assigned to the IAWA cohort, the primary exposure. Confounding variables included basic demographics, baseline health status, and surgical facility characteristics. The primary outcomes studied were medical complications, implant-related complications, and admission mortality. Univariate and adjusted multivariable regression analyses were used to identify associations.<\/jats:p><jats:p>Compared to patients in the non-IAWA cohort, those in the IAWA cohort had significant risks for same-admission medical complications (odds ratio [OR] 5.77, 95% confidence interval [CI] 4.59\u20137.15; p\u2009&lt;\u20090.001), implant-related complications (OR 1.55, 95% CI 1.09\u20132.12; p\u2009=\u20090.009), stroke (OR 77.46, 95% CI 58.4\u2013101.2; p\u2009&lt;\u20090.001), venous thromboembolism (VTE; OR 3.78 95% CI 2.47\u20135.51; p\u2009&lt;\u20090.001), and mortality (OR 8.36, 95% CI 3.54\u201316.52; p\u2009&lt;\u20090.001) following TKA.<\/jats:p><jats:p>Compared to patients without IAWAs, those with IAWAs who undergo TKA have higher risks for same-admission medical and implant-related complications as well as same-admission mortality. Similarly, these patients have higher risks for same-admission stroke and VTE. Further research on perioperative TKA management in patients with IAWAs is needed.<\/jats:p><jats:p>Level of Evidence is III: retrospective cohort study.<\/jats:p>","DOI":"10.1055\/a-2376-6810","type":"journal-article","created":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T23:22:00Z","timestamp":1722468120000},"page":"966-972","source":"Crossref","is-referenced-by-count":0,"title":["Interatrial Wall Abnormality is Associated with Adverse Same-Admission Outcomes Following Total Knee Arthroplasty"],"prefix":"10.1055","volume":"37","author":[{"given":"Bruce B.","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah A.","family":"Uddin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David H.","family":"Mai","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Declan","family":"Tozzi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam J.","family":"Wolfert","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qais","family":"Naziri","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,9,2]]},"reference":[{"issue":"11","key":"ref1","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1016\/j.joca.2017.07.022","article-title":"Projected increase in total knee arthroplasty in the United States - an alternative projection model","volume":"25","author":"M CS Inacio","year":"2017","journal-title":"Osteoarthritis Cartilage"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1097\/ALN.0b013e318216e7f4","article-title":"Perioperative stroke and associated mortality after noncardiac, nonneurologic surgery","volume":"114","author":"G A Mashour","year":"2011","journal-title":"Anesthesiology"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/ALN.0b013e318194b5ff","article-title":"Perioperative acute ischemic stroke in noncardiac and nonvascular surgery: incidence, risk factors, and outcomes","volume":"110","author":"B T Bateman","year":"2009","journal-title":"Anesthesiology"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1302\/0301-620X.96B4.33209","article-title":"The risk of venous thromboembolism, myocardial infarction, stroke, major bleeding and death in patients undergoing total hip and knee replacement: a 15-year retrospective cohort study of routine clinical practice","volume":"96-B","author":"A B Pedersen","year":"2014","journal-title":"Bone Joint J"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1097\/BLO.0b013e31805b7681","article-title":"The 2007 ABJS Nicolas Andry Award: three decades of clinical, basic, and applied research on thromboembolic disease after THA: rationale and clinical results of a multimodal prophylaxis protocol","volume":"459","author":"E A Salvati","year":"2007","journal-title":"Clin Orthop Relat Res"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.jacc.2014.04.063","article-title":"Paradoxical embolism","volume":"64","author":"S Windecker","year":"2014","journal-title":"J Am Coll Cardiol"},{"issue":"21","key":"ref7","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1016\/j.jacc.2011.08.025","article-title":"Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis","volume":"58","author":"D van der Linde","year":"2011","journal-title":"J Am Coll Cardiol"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S0025-6196(12)60336-X","article-title":"Incidence and size of patent foramen ovale during the first 10 decades of life: an autopsy study of 965 normal hearts","volume":"59","author":"P T Hagen","year":"1984","journal-title":"Mayo Clin Proc"},{"issue":"09","key":"ref9","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1093\/eurheartj\/ehac727","article-title":"Lifetime risk of comorbidity in patients with simple congenital heart disease: a Danish nationwide study","volume":"44","author":"M El-Chouli","year":"2023","journal-title":"Eur Heart J"},{"issue":"07","key":"ref10","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1016\/j.amjcard.2019.06.030","article-title":"Atrial septal defect and the risk of ischemic stroke in the perioperative period of noncardiac surgery","volume":"124","author":"N R Smilowitz","year":"2019","journal-title":"Am J Cardiol"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1093\/aje\/kwq433","article-title":"Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries","volume":"173","author":"H Quan","year":"2011","journal-title":"Am J Epidemiol"},{"key":"ref13","first-page":"177","article-title":"Does atrial septal defect increase the risk of stroke following total hip and knee arthroplasty?","volume":"31","author":"M Chughtai","year":"2017","journal-title":"Surg Technol Int"},{"issue":"10","key":"ref14","doi-asserted-by":"crossref","first-page":"3152","DOI":"10.1016\/j.arth.2017.05.006","article-title":"Atrial septal defect increases the risk for stroke after total hip arthroplasty","volume":"32","author":"D C Perfetti","year":"2017","journal-title":"J Arthroplasty"},{"issue":"10","key":"ref15","doi-asserted-by":"crossref","first-page":"2126","DOI":"10.1016\/j.arth.2023.05.004","article-title":"Postoperative complications, readmissions, lengths of stay, and cost analyses of patients who have atrial septal defects after total joint arthroplasty","volume":"38","author":"M L Magruder","year":"2023","journal-title":"J Arthroplasty"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.artd.2022.07.005","article-title":"Total joint arthroplasty in patients with atrial septal defects: what are the 90-day complications?","volume":"17","author":"J Bido","year":"2022","journal-title":"Arthroplast Today"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.arth.2007.03.007","article-title":"Does \u201cexcessive\u201d anticoagulation predispose to periprosthetic infection?","volume":"22","author":"J Parvizi","year":"2007","journal-title":"J Arthroplasty"},{"issue":"12","key":"ref18","doi-asserted-by":"crossref","first-page":"e20.00021","DOI":"10.2106\/JBJS.RVW.20.00021","article-title":"Comparison of surgical site infection risk between warfarin, LMWH, and aspirin for venous thromboprophylaxis in TKA or THA: a systematic review and meta-analysis","volume":"8","author":"L D Hughes","year":"2020","journal-title":"JBJS Rev"},{"issue":"04","key":"ref19","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.arth.2018.12.015","article-title":"Utilization patterns, efficacy, and complications of venous thromboembolism prophylaxis strategies in primary hip and knee arthroplasty as reported by American Board of Orthopedic Surgery Part II Candidates","volume":"34","author":"R P Runner","year":"2019","journal-title":"J Arthroplasty"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"10579","DOI":"10.1038\/s41598-022-14749-y","article-title":"Pharmacological thromboprophylaxis as a risk factor for early periprosthetic joint infection following primary total joint arthroplasty","volume":"12","author":"F Y Pai","year":"2022","journal-title":"Sci Rep"},{"issue":"441","key":"ref21","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1097\/01.blo.0000192366.61616.81","article-title":"The John Charnley Award: heritable thrombophilia and development of thromboembolic disease after total hip arthroplasty","volume":"441","author":"E A Salvati","year":"2005","journal-title":"Clin Orthop Relat Res"},{"issue":"15","key":"ref22","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1001\/jama.2020.17024","article-title":"Medical care of adults with Down syndrome: a clinical guideline","volume":"324","author":"A Y Tsou","year":"2020","journal-title":"JAMA"}],"container-title":["The Journal of Knee Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2376-6810.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T14:53:27Z","timestamp":1730818407000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2376-6810"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,31]]},"references-count":21,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2024,10,28]]},"published-print":{"date-parts":[[2024,12]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2376-6810","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1538-8506","1938-2480"],"issn-type":[{"type":"print","value":"1538-8506"},{"type":"electronic","value":"1938-2480"}],"subject":[],"published-other":{"date-parts":[[2024,7,31]]},"published":{"date-parts":[[2024,7,31]]}}}