Hypoxemia After Total Joint Arthroplasty: A Problem on the Rise
Received 25 October 2007; accepted 2 May 2008.
Abstract
Total joint arthroplasty (TJA) is categorized as a major risk factor for thromboembolic complications. The importance of hypoxemia during the postoperative period is subject of controversy. This prospective study elucidates the incidence and etiology of hypoxemia after TJA. Furthermore, we intended to assess the predictive value of clinical findings in identifying the etiology of hypoxemia after TJA. Of 1971 patients, 78 (4.0%) experienced an acute episode of hypoxemia during their hospitalization after TJA. Hypoxemia as the initial presenting sign, predicted major complications, defined as life-threatening if left untreated, in 32% of the hypoxic population. These diagnoses included pulmonary embolism, pulmonary edema, and pneumonia. Tachypnea was the only independent factor associated with pulmonary embolism. Our study presents the incidence and etiology of hypoxemia after TJA, and we recommend a heightened appreciation for the hypoxemic patient.
Rothman Institute of Orthopedics at Thomas Jefferson University, Philadelphia, Pennsylvania
Reprint requests: Javad Parvizi, MD, Rothman Institute of Orthopedics at Thomas Jefferson Hospital, 925 Chestnut St, Philadelphia, PA 19107.
Each author certifies that their institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.
Benefits or funds were received in partial or total support of the research material described in this article. These benefits or support were received from Stryker Orthopedics, Mahwah, New Jersey (Dr J Parvizi and Dr R Rothman).
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