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Predictors of Postoperative Pulmonary Complication After Total Hip Replacement in Elderly FREE TO VIEW

Jung Hyun Chang, PhD; Seok Jeong Lee; Yon Ju Ryu, PhD; Jin Hwa Lee, PhD
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Pulmonology and Critical Care Medicine, Ewha Womans University, Seoul, Republic of Korea

Chest. 2014;146(4_MeetingAbstracts):501A. doi:10.1378/chest.1983751
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SESSION TITLE: Outcomes/Quality Control Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Total hip replacement (THR) is effective procedure for various conditions such as osteoarthritis or infections. However, postoperative respiratory complications can occur especially in elderly. The aim of this study was to describe the clinical features and outcomes and assess the predictive factors for postoperative pulmonary complication (PPC) in elderly undergoing elective THR.

METHODS: Following a retrospective review of clinical data and radiographic findings from January, 2008 to December, 2012, total 141 patients aged 65 years and over who underwent elective THR were enrolled.

RESULTS: The median age of the patients was 72 year (65-95) and 58.2 % (n = 82) was female. Twenty seven (19.1%) patients had underwent postoperative pulmonary complication. Pneumonia developed in 7 patients (4.96 %), atelectasis in 8 (5.67 %), pulmonary edema in 16 (11.35 %), pleural effusion in 6 (4.26 %), and pulmonary embolism in 2 (1.42 %) patients. Two patients (1.42 %) developed acute respiratory failure requiring mechanical ventilation. There was no respiratory complication-related mortality. The factors associated with PPC by univariate analysis (p < 0.2) were age (p = 0.015), right ventricular systolic pressure (RVSP) (p = 0.186), DM (p = 0.048), COPD (p = 0.124) and ischemic heart disease (IHD) (p = 0.038). There was no significant relationship between development of PPC and BMI, duration of operation, transfusion, or fluid infusion amount. In the multivariate analysis model with these five factors, IHD (OR = 4.07, CI = 1.05-15.73, p = 0.042) was the independent predictive factor for PPC.

CONCLUSIONS: IHD predicted PPC after elective THR whereas age and underlying airway obstructive disease did not.

CLINICAL IMPLICATIONS: Total hip replacement surgery in elderly subjects should give attention to postoperative pulmonary complication in subjects of IHD rather than COPD.

DISCLOSURE: The following authors have nothing to disclose: Jung Hyun Chang, Seok Jeong Lee, Yon Ju Ryu, Jin Hwa Lee

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