{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:49:43Z","timestamp":1747187383056,"version":"3.40.5"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T00:00:00Z","timestamp":1702944000000},"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":[[2024,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Blood pressure (BP) fluctuation has been demonstrated to be closely associated with stroke. However, at present, no attention is paid to the BP fluctuation following total knee arthroplasty (TKA). The aim of this study is to investigate what is BP fluctuation patterns in stroke and transient ischemic attack (TIA) patients after primary TKA, compare clinical characteristics among different BP fluctuation patterns and determine whether it could predict the occurrence of a 90\u2010day stroke.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study was conducted from February 1, 2011 to February 15, 2021. Stroke or TIA patients within 90\u2009days after TKA were included. Data from a hospitalization management system were analyzed, including demographics, smoking status, comorbidities, medications, surgical variables, and 90\u2010day stroke, mortality, and readmission rates. BP fluctuation patterns were defined based on the average BP in the first 3\u2009days after TKA. A logistic regression analysis model was used to identify risk factors for 90\u2010day stroke or TIA following TKA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 1687 patients who underwent primary TKA, 4.0% (68\/1687) experienced a 90\u2010day stroke or TIA. A total of 63 patients met the inclusion criteria, with an average age of 67.5\u2009years and 55.6% (35\/63) female. The number of stroke or TIA patients in each BP fluctuation pattern (T1\u2013T5) was 6 (9.5%), 5 (7.9%), 4 (6.3%), 13 (20.6%), and 35 (55.6%) respectively. Patients with a T5 pattern tended to be older and had a greater reduction in average systolic blood pressure (SBP) 3\u2009days after surgery compared to other patterns. The T5 pattern was associated with a higher occurrence of stroke and a lower occurrence of TIA. Patients with a T5 pattern also had a longer length of stay within 90\u2009days following TKA. After adjusting for confounding factors, average SBP fluctuation \u226540\u2009mmHg and the T5 pattern of BP fluctuation remained risk factors for 90\u2010day stroke or TIA after TKA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>BP fluctuation patterns in the early postoperative period are associated with 90\u2010day stroke and TIA following primary TKA.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13942","type":"journal-article","created":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T02:39:10Z","timestamp":1703039950000},"page":"383-390","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Blood Pressure Fluctuation Pattern Associated with 90\u2010Day Ischemic Stroke and Transient Ischemic Attack After Total Knee Arthroplasty\u2014A Retrospective Study"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3023-1160","authenticated-orcid":false,"given":"Xiao","family":"An","sequence":"first","affiliation":[{"name":"PLA General Hospital, Medical College of Chinese PLA  Beijing China"},{"name":"Department of Orthopaedics Hainan Hospital of Chinese PLA General Hospital  Sanya Hainan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Quality Management Department PLA Rocket Force Characteristic Medical Center  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhirui","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Hainan Hospital of Chinese PLA General Hospital  Sanya Hainan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuxiang","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiying","family":"Chen","sequence":"additional","affiliation":[{"name":"PLA General Hospital, Medical College of Chinese PLA  Beijing 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