{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:34:43Z","timestamp":1791221683244,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:00:00Z","timestamp":1623196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2021,7]]},"abstract":"\n Objective<\/jats:title>\n To examine the incidence and risk factors of in\u2010hospital prosthesis\u2010related complications (PRCs) following total knee arthroplasty (TKA) using a large\u2010scale national database.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective database analysis was performed based on Nationwide Inpatient Sample (NIS) from 2005\u20132014. Patients who underwent TKA were included. The recruited cases were divided into two groups according to the occurrence of PRCs. Patient demographics (age, sex, and race), hospital characteristics (type of admission and payer, and bedsize, teaching status, location, and region of hospital), length of stay (LOS), total charges during hospitalization, in\u2010hospital mortality, comorbidities, and perioperative complications were analyzed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 1,227,244 TKAs were captured from the NIS database. There were 8484 cases of in\u2010hospital PRCs after TKA and the overall incidence was 0.69%, with a slight downward trend annually. Periprosthetic joint infection (PJI) was the main category among PRCs (0.20%), followed by mechanical loosening (0.04%), dislocation (0.02%), and periprosthetic fracture (PPF) (0.01%). Patients suffered from in\u2010hospital PRCs were 3\u2009years younger (64\u2009years\n vs<\/jats:italic>\n 67\u2009years) and 6.51% more likely to be male (43.60%\n vs<\/jats:italic>\n 37.09%) compared to the nonaffected population (\n P<\/jats:italic>\n \u2009<\u20090.0001). Additionally, patients experiencing in\u2010hospital PRCs after TKA were 2.11% less likely through elective admission (92.07%\n vs<\/jats:italic>\n 94.18%) while 2.34% more likely in teaching hospital (45.53%\n vs<\/jats:italic>\n 43.19%) than those without these complications (\n P<\/jats:italic>\n \u2009<\u20090.0001). Furthermore, the occurrence of in\u2010hospital PRCs was associated with longer LOS (4\u2009days\n vs<\/jats:italic>\n 3\u2009days;\n P<\/jats:italic>\n \u2009<\u20090.0001), more total charges ($53,418\n vs<\/jats:italic>\n $41,204,\n P<\/jats:italic>\n \u2009<\u20090.0001), and higher in\u2010hospital mortality (0.30%\n vs<\/jats:italic>\n 0.07%;\n P<\/jats:italic>\n \u2009<\u20090.0001). Multivariate logistic regression was performed to identify independent risk factors of in\u2010hospital PRCs after TKA which included younger age, male, non\u2010elective admission, teaching hospital, deficiency and chronic blood loss anemia, coagulopathy, congestive heart failure, depression, diabetes with chronic complications, fluid and electrolyte disorders, pulmonary circulation disorders, metastatic cancer, and weight loss. Besides, in\u2010hospital PRCs after TKA were associated with secondary osteoarthritis, inflammatory arthritis, prior knee arthroscopy, acute renal failure, acute myocardial infarction, deep vein thrombosis, sepsis, transfusion, and wound dehiscence.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n It is beneficial to study the risk factors of in\u2010hospital PRCs after TKA to ensure the appropriate management and optimize consequences although a relatively low incidence was identified.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/os.13008","type":"journal-article","created":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T17:27:16Z","timestamp":1623346036000},"page":"1579-1586","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Incidence and Risk Factors of\n In\u2010Hospital Prosthesis\u2010Related<\/scp>\n Complications Following Total Knee Arthroplasty: A Retrospective Nationwide Inpatient Sample Database Study"],"prefix":"10.1111","volume":"13","author":[{"given":"Qin\u2010feng","family":"Yang","sequence":"first","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ze\u2010ming","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pin\u2010kai","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3104-5239","authenticated-orcid":false,"given":"Jian","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital Southern Medical University Guangzhou 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