The role of preoperative aspartate aminotransferase-to-platelet ratio index in predicting complications following total hip arthroplasty.


Journal

BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565

Informations de publication

Date de publication:
02 Dec 2023
Historique:
received: 24 07 2023
accepted: 25 11 2023
medline: 4 12 2023
pubmed: 3 12 2023
entrez: 2 12 2023
Statut: epublish

Résumé

The purpose of this study was to investigate the relationship between preoperative aspartate aminotransferase-to-platelet ratio index (APRI) and postoperative complications following total hip arthroplasty (THA). All THA for osteoarthritis patients from 2007 to 2020 within the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database were included in this study. Subjects were subsequently divided into cohorts based on APRI. Four groups, including normal range, some liver damage, significant fibrosis, and cirrhosis groups, were created. Comparisons between groups were made for demographics, past medical history, and rate of major and minor complications. Other outcomes included readmission, reoperation, discharge destination, mortality, periprosthetic fracture, and postoperative hip dislocation. Multivariate logistic regression analysis was performed to determine the role of preoperative APRI in predicting adverse outcomes. Statistical significance was set at p < 0.05. In total, 104,633 primary THA patients were included in this study. Of these, 103,678 (99.1%) were in the normal APRI group, 444 (0.4%) had some liver damage, 256 (0.2%) had significant fibrosis, and 253 (0.2%) had cirrhosis. When controlling for demographics and relevant past medical history, the abnormal APRI groups had a significantly higher likelihood of major complication, minor complication, intraoperative or postoperative bleeding requiring transfusion, readmission, and non-home discharge (all p < 0.05) compared to normal APRI individuals. Abnormal preoperative APRI is linked with an increasing number of adverse outcomes following THA for osteoarthritis for patients across the United States. Level I.

Sections du résumé

BACKGROUND BACKGROUND
The purpose of this study was to investigate the relationship between preoperative aspartate aminotransferase-to-platelet ratio index (APRI) and postoperative complications following total hip arthroplasty (THA).
METHODS METHODS
All THA for osteoarthritis patients from 2007 to 2020 within the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database were included in this study. Subjects were subsequently divided into cohorts based on APRI. Four groups, including normal range, some liver damage, significant fibrosis, and cirrhosis groups, were created. Comparisons between groups were made for demographics, past medical history, and rate of major and minor complications. Other outcomes included readmission, reoperation, discharge destination, mortality, periprosthetic fracture, and postoperative hip dislocation. Multivariate logistic regression analysis was performed to determine the role of preoperative APRI in predicting adverse outcomes. Statistical significance was set at p < 0.05.
RESULTS RESULTS
In total, 104,633 primary THA patients were included in this study. Of these, 103,678 (99.1%) were in the normal APRI group, 444 (0.4%) had some liver damage, 256 (0.2%) had significant fibrosis, and 253 (0.2%) had cirrhosis. When controlling for demographics and relevant past medical history, the abnormal APRI groups had a significantly higher likelihood of major complication, minor complication, intraoperative or postoperative bleeding requiring transfusion, readmission, and non-home discharge (all p < 0.05) compared to normal APRI individuals.
CONCLUSIONS CONCLUSIONS
Abnormal preoperative APRI is linked with an increasing number of adverse outcomes following THA for osteoarthritis for patients across the United States.
LEVEL OF EVIDENCE METHODS
Level I.

Identifiants

pubmed: 38042799
doi: 10.1186/s12891-023-07063-9
pii: 10.1186/s12891-023-07063-9
pmc: PMC10693101
doi:

Substances chimiques

Aspartate Aminotransferases EC 2.6.1.1

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

934

Informations de copyright

© 2023. The Author(s).

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Auteurs

M A McLellan (MA)

Department of Orthopaedic Surgery, University of California Irvine, 101 The City Drive South, Pavilion III, Building 29A, Orange, CA, 92868, USA. maddisam@hs.uci.edu.

M R Donnelly (MR)

Department of Orthopaedic Surgery, New York University, New York, USA.

K T Callan (KT)

Department of Orthopaedic Surgery, University of California Irvine, 101 The City Drive South, Pavilion III, Building 29A, Orange, CA, 92868, USA.

B E Lung (BE)

Department of Orthopaedic Surgery, University of California Irvine, 101 The City Drive South, Pavilion III, Building 29A, Orange, CA, 92868, USA.

S Liu (S)

Stony Brook School of Medicine, New York, USA.

R DiGiovanni (R)

Department of Orthopaedic Surgery, University of California Irvine, 101 The City Drive South, Pavilion III, Building 29A, Orange, CA, 92868, USA.

W C McMaster (WC)

Department of Orthopaedic Surgery, University of California Irvine, 101 The City Drive South, Pavilion III, Building 29A, Orange, CA, 92868, USA.

R N Stitzlein (RN)

Department of Orthopaedic Surgery, University of California Irvine, 101 The City Drive South, Pavilion III, Building 29A, Orange, CA, 92868, USA.

S Yang (S)

Department of Orthopaedic Surgery, University of California Irvine, 101 The City Drive South, Pavilion III, Building 29A, Orange, CA, 92868, USA.

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Classifications MeSH