Effect of Anesthetic Technique on the Occurrence of Acute Kidney Injury after Total Knee Arthroplasty
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Anesthesia
2.3. Clinical Data
2.4. Definitions of Outcomes
2.5. Statistical Analysis
3. Results
4. Discussion
Author Contributions
Conflicts of Interest
References
- Koh, I.J.; Kim, T.K.; Chang, C.B.; Cho, H.J.; In, Y. Trends in use of total knee arthroplasty in Korea from 2001 to 2010. Clin. Orthop. Relat. Res. 2013, 471, 1441–1450. [Google Scholar] [CrossRef] [PubMed]
- Kurtz, S.; Ong, K.; Lau, E.; Mowat, F.; Halpern, M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J. Bone Joint Surg. Am. 2007, 89, 780–785. [Google Scholar] [PubMed]
- Kim, Y.H.; Kim, J.S.; Choe, J.W.; Kim, H.J. Long-term comparison of fixed-bearing and mobile-bearing total knee replacements in patients younger than fifty-one years of age with osteoarthritis. J. Bone Joint Surg. Am. 2012, 94, 866–873. [Google Scholar] [CrossRef] [PubMed]
- Turnbull, Z.A.; Sastow, D.; Giambrone, G.P.; Tedore, T. Anesthesia for the patient undergoing total knee replacement: Current status and future prospects. Local Reg. Anesth. 2017, 10, 1–7. [Google Scholar] [CrossRef] [PubMed]
- Brull, R.; McCartney, C.J.; Chan, V.W.; El-Beheiry, H. Neurological complications after regional anesthesia: Contemporary estimates of risk. Anesth. Analg. 2007, 104, 965–974. [Google Scholar] [CrossRef] [PubMed]
- Macfarlane, A.J.; Prasad, G.A.; Chan, V.W.; Brull, R. Does regional anesthesia improve outcome after total knee arthroplasty? Clin. Orthop. Relat. Res. 2009, 467, 2379–2402. [Google Scholar] [CrossRef] [PubMed]
- Memtsoudis, S.G.; Sun, X.; Chiu, Y.-L.; Stundner, O.; Liu, S.S.; Banerjee, S.; Mazumdar, M.; Sharrock, N.E. Perioperative comparative effectiveness of anesthetic technique in orthopedic patients. Anesthesiology 2013, 118, 1046–1058. [Google Scholar] [CrossRef]
- Pugely, A.J.; Martin, C.T.; Gao, Y.; Mendoza-Lattes, S.; Callaghan, J.J. Differences in short-term complications between spinal and general anesthesia for primary total knee arthroplasty. J. Bone Joint Surg. Am. 2013, 95, 193–199. [Google Scholar] [CrossRef]
- Davis, F.M.; Laurenson, V.G.; Gillespie, W.J.; Wells, J.E.; Foate, J.; Newman, E. Deep vein thrombosis after total hip replacement. A comparison between spinal and general anaesthesia. J. Bone Joint Surg. Br. 1989, 71, 181–185. [Google Scholar] [CrossRef]
- Planes, A.; Vochelle, N.; Fagola, M.; Feret, J.; Bellaud, M. Prevention of deep vein thrombosis after total hip replacement. The effect of low-molecular-weight heparin with spinal and general anaesthesia. J. Bone Joint Surg. Br. 1991, 73, 418–422. [Google Scholar] [CrossRef]
- Stundner, O.; Chiu, Y.L.; Sun, X.; Mazumdar, M.; Fleischut, P.; Poultsides, L.; Gerner, P.; Fritsch, G.; Memtsoudis, S.G. Comparative perioperative outcomes associated with neuraxial versus general anesthesia for simultaneous bilateral total knee arthroplasty. Reg. Anesth. Pain Med. 2012, 37, 638–644. [Google Scholar] [CrossRef] [PubMed]
- Kim, H.J.; Koh, W.U.; Kim, S.G.; Park, H.S.; Song, J.G.; Ro, Y.J.; Yang, H.S. Early postoperative albumin level following total knee arthroplasty is associated with acute kidney injury: A retrospective analysis of 1309 consecutive patients based on kidney disease improving global outcomes criteria. Medicine 2016, 95, e4489. [Google Scholar] [CrossRef] [PubMed]
- Warth, L.C.; Noiseux, N.O.; Hogue, M.H.; Klaassen, A.L.; Liu, S.S.; Callaghan, J.J. Risk of acute kidney injury after primary and revision total hip arthroplasty and total knee arthroplasty using a multimodal approach to perioperative pain control including ketorolac and celecoxib. J. Arthroplasty 2016, 31, 253–255. [Google Scholar] [CrossRef] [PubMed]
- Biteker, M.; Dayan, A.; Tekkesin, A.I.; Can, M.M.; Tayci, I.; Ilhan, E.; Sahin, G. Incidence, risk factors, and outcomes of perioperative acute kidney injury in noncardiac and nonvascular surgery. Am. J. Surg. 2014, 207, 53–59. [Google Scholar] [CrossRef] [PubMed]
- Suleiman, M.Y.; Passannante, A.N.; Onder, R.L.; Greene-Helms, W.F.; Perretta, S.G. Alteration of renal blood flow during epidural anesthesia in normal subjects. Anesth. Analg. 1997, 84, 1076–1080. [Google Scholar] [CrossRef] [PubMed]
- DiBona, G.F. Neural control of renal function in health and disease. Clin. Auton. Res. 1994, 4, 69–74. [Google Scholar] [CrossRef] [PubMed]
- Pelayo, J.C.; Tucker, B.J.; Blantz, R.C. Effects of beta-adrenergic stimulation with isoproterenol on glomerular hemodynamics. Am. J. Physiol. 1989, 257, F866–F873. [Google Scholar] [CrossRef] [PubMed]
- Gonano, C.; Leitgeb, U.; Sitzwohl, C.; Ihra, G.; Weinstabl, C.; Kettner, S.C. Spinal versus general anesthesia for orthopedic surgery: Anesthesia drug and supply costs. Anesth. Analg. 2006, 102, 524–529. [Google Scholar] [CrossRef]
- Jellish, W.S.; Thalji, Z.; Stevenson, K.; Shea, J. A prospective randomized study comparing short-and intermediate-term perioperative outcome variables after spinal or general anesthesia for lumbar disk and laminectomy surgery. Anesth. Analg. 1996, 83, 559–564. [Google Scholar] [CrossRef]
- Korhonen, A.-M.; Valanne, J.V.; Jokela, R.M.; Ravaska, P.; Korttila, K.T. A comparison of selective spinal anesthesia with hyperbaric bupivacaine and general anesthesia with desflurane for outpatient knee arthroscopy. Anesth. Analg. 2004, 99, 1668–1673. [Google Scholar] [CrossRef]
- Carr, D.B.; Goudas, L.C. Acute pain. Lancet 1999, 353, 2051–2058. [Google Scholar] [CrossRef]
- Kehlet, H.; Dahl, J.B. Anaesthesia, surgery, and challenges in postoperative recovery. Lancet 2003, 362, 1921–1928. [Google Scholar] [CrossRef]
- Boehne, M.; Sasse, M.; Karch, A.; Dziuba, F.; Horke, A.; Kaussen, T.; Mikolajczyk, R.; Beerbaum, P.; Jack, T. Systemic inflammatory response syndrome after pediatric congenital heart surgery: Incidence, risk factors, and clinical outcome. J. Card. Surg. 2017, 32, 116–125. [Google Scholar] [CrossRef] [PubMed]
- Park, J.T. Postoperative acute kidney injury. Korean J. Anesthesiol. 2017, 70, 258–266. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Berry, M.; Clatworthy, M.R. Immunotherapy for acute kidney injury. Immunotherapy 2012, 4, 323–334. [Google Scholar] [CrossRef] [PubMed]
- Nechemia-Arbely, Y.; Barkan, D.; Pizov, G.; Shriki, A.; Rose-John, S.; Galun, E.; Axelrod, J.H. IL-6/IL-6R axis plays a critical role in acute kidney injury. J. Am. Soc. Nephrol. 2008, 19, 1106–1115. [Google Scholar] [CrossRef]
- Song, J.W.; Goligorsky, M.S. Perioperative implication of the endothelial glycocalyx. Korean J. Anesthesiol. 2018, 71, 92–102. [Google Scholar] [CrossRef] [Green Version]
- Milosavljevic, S.B.; Pavlovic, A.P.; Trpkovic, S.V.; Ilić, A.N.; Sekulic, A.D. Influence of spinal and general anesthesia on the metabolic, hormonal, and hemodynamic response in elective surgical patients. Med. Sci. Monit. 2014, 20, 1833–1840. [Google Scholar]
- Buyukkocak, U.; Daphan, C.; Caglayan, O.; Aydinuraz, K.; Kaya, T.; Saygun, O.; Agalar, F. Effects of different anesthetic techniques on serum leptin, C-reactive protein, and cortisol concentrations in anorectal surgery. Croat. Med. J. 2006, 47, 862–868. [Google Scholar]
- Bugada, D.; Ghisi, D.; Mariano, E.R. Continuous regional anesthesia: A review of perioperative outcome benefits. Minerva Anestesiol. 2017, 83, 1089–1100. [Google Scholar]
- Lirk, P.; Picardi, S.; Hollmann, M.W. Local anaesthetics: 10 essentials. Eur. J. Anaesthesiol. 2014, 31, 575–585. [Google Scholar] [CrossRef] [PubMed]
- Lirk, P.; Fiegl, H.; Weber, N.; Hollmann, M. Epigenetics in the perioperative period. Br. J. Pharmacol. 2015, 172, 2748–2755. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Rasmussen, L.E.; Holm, H.A.; Kristensen, P.W.; Kjaersgaard-Andersen, P. Tourniquet time in total knee arthroplasty. Knee 2018, 25, 306–313. [Google Scholar] [CrossRef] [PubMed]
- Zarbock, A.; Koyner, J.L.; Hoste, E.A.; Kellum, J.A. Update on perioperative acute kidney injury. Anesth. Analg. 2018, 127, 1236–1245. [Google Scholar] [CrossRef] [PubMed]
- Miskovic, A.; Lumb, A.B. Postoperative pulmonary complications. Br. J. Anaesth. 2017, 118, 317–334. [Google Scholar] [CrossRef] [Green Version]
- Turan, A.; Bajracharya, G.R.; Leung, S.; Yazici Kara, M.; Mao, G.; Botsford, T.; Ruetzler, K.; Maheshwari, K.; Ali Sakr Esa, W.; Elsharkawy, H.; et al. Association of neuraxial anesthesia with postoperative venous thromboembolism after noncardiac surgery: A propensity-matched analysis of ACS-NSQIP database. Anesth. Analg. 2019, 128, 494–501. [Google Scholar] [CrossRef] [PubMed]
- Mauermann, W.J.; Shilling, A.M.; Zuo, Z. A comparison of neuraxial block versus general anesthesia for elective total hip replacement: A meta-analysis. Anesth. Analg. 2006, 103, 1018–1025. [Google Scholar] [CrossRef]
- Smith, L.M.; Cozowicz, C.; Uda, Y.; Memtsoudis, S.G.; Barrington, M.J. Neuraxial and combined neuraxial/general anesthesia compared to general anesthesia for major truncal and lower limb surgery: A systematic review and meta-analysis. Anesth. Analg. 2017, 125, 1931–1945. [Google Scholar] [CrossRef]
- Hu, S.; Zhang, Z.Y.; Hua, Y.Q.; Li, J.; Cai, Z.D. A comparison of regional and general anaesthesia for total replacement of the hip or knee: A meta-analysis. J. Bone Joint Surg. Br. 2009, 91, 935–942. [Google Scholar] [CrossRef]
- Walker, J.B.; Nguyen, P.L.; Schmidt, U.H.; Gabriel, R.A. Postoperative outcomes associated with neuraxial vs general anesthesia following bilateral total knee arthroplasty. J. Arthroplasty 2017, 32, 3632–3636. [Google Scholar] [CrossRef]
- Johnson, R.L.; Kopp, S.L.; Burkle, C.M.; Duncan, C.M.; Jacob, A.K.; Erwin, P.J.; Murad, M.H.; Mantilla, C.B. Neuraxial vs general anaesthesia for total hip and total knee arthroplasty: A systematic review of comparative-effectiveness research. Br. J. Anaesth. 2016, 116, 163–176. [Google Scholar] [CrossRef] [PubMed]
- Helwani, M.A.; Avidan, M.S.; Ben Abdallah, A.; Kaiser, D.J.; Clohisy, J.C.; Hall, B.L.; Kaiser, H.A. Effects of regional versus general anesthesia on outcomes after total hip arthroplasty: A retrospective propensity-matched cohort study. J. Bone Joint Surg. Am. 2015, 97, 186–193. [Google Scholar] [CrossRef] [PubMed]
- Cryer, C.; Gulliver, P.; Langley, J.D.; Davie, G. Is length of stay in hospital a stable proxy for injury severity? Inj. Prev. 2010, 16, 254–260. [Google Scholar] [CrossRef] [PubMed]
- McIsaac, D.I.; McCartney, C.J.; Walraven, C.V. Peripheral Nerve Blockade for Primary Total Knee Arthroplasty: A population-based cohort study of outcomes and resource utilization. Anesthesiology 2017, 126, 312–320. [Google Scholar] [CrossRef] [PubMed]
- El Bitar, Y.F.; Illingworth, K.D.; Scaife, S.L.; Horberg, J.V.; Saleh, K.J. Hospital length of stay following primary total knee arthroplasty: Data from the nationwide inpatient sample database. J. Arthroplasty 2015, 30, 1710–1715. [Google Scholar] [CrossRef]
Demographic Data | General (N = 2353) | Spinal (N = 634) | p-Value | Standardized Difference |
---|---|---|---|---|
Age (years) | 68.6 ± 6.6 | 69.3 ± 6.4 | 0.027 | 0.102 |
Body mass index (kg/m2) | 26.8 ± 3.5 | 26.5 ± 3.2 | 0.048 | 0.090 |
Sex, Female/male | 2174 / 179 (92.4/7.6) | 568 / 66 (89.6 / 10.4) | 0.022 | 0.092 |
ASA PS †, 1/2/3 | 129/2157/67 (5.5/91.7/2.9) | 21/581/32 (3.3/91.6/5.1) | 0.003 | 0.152 |
Smoking History Non/current/ex-smoker | 2039/52/262 (86.7/2.2/11.1) | 325/19/290 (51.3/3/45.7) | <0.001 | 0.844 |
Surgical Data | ||||
Surgical strategy, Single/staggered/staged_1st/ staged_2nd/simultaneous | 983/380/149/146/695 (41.8/16.2/6.3/6.2/29.5) | 334/175/29/32/64 (52.7/27.6/4.6/5.1/10.1) | <0.001 | 0.553 |
Surgeon, B/C/K | 719/1173/461 (30.6/49.9/19.6) | 326/273/35 (51.4/43.1/5.5) | <0.001 | 0.542 |
Preoperative Medical History | ||||
Diabetes mellitus | 306 (13.0) | 105 (16.6) | 0.021 | 0.096 |
Hypertension | 768 (32.6) | 261 (41.2) | <0.001 | 0.173 |
Ischemic heart disease | 164 (7.0) | 63 (9.9) | 0.012 | 0.099 |
Cerebrovascular disease | 127 (5.4) | 45 (7.1) | 0.103 | 0.066 |
Pulmonary disease | 88 (3.7) | 35 (5.5) | 0.045 | 0.078 |
Adrenal disease | 33 (1.4) | 7 (1.1) | 0.562 | 0.029 |
Preoperative Medication History | ||||
Calcium channel blocker | 927 (39.4) | 243 (38.3) | 0.625 | 0.022 |
Angiotensin-converting enzyme inhibitor | 803 (34.1) | 220 (34.7) | 0.787 | 0.012 |
Beta blocker | 360 (15.3) | 106 (16.7) | 0.382 | 0.038 |
Aspirin | 512 (21.8) | 135 (21.3) | 0.800 | 0.011 |
Clopidogrel | 150 (6.4) | 58 (9.2) | 0.015 | 0.096 |
HMG-CoA reductase inhibitors ‡ | 600 (25.5) | 234 (36.9) | <0.001 | 0.236 |
Antibiotics | 12 (0.5) | 1 (0.2) | 0.323 | 0.089 |
Nonsteroidal anti-inflammatory drugs | 187 (8.0) | 33 (5.2) | 0.019 | 0.123 |
Selective cyclooxygenase-2 inhibitor | 408 (17.3) | 140 (22.1) | 0.006 | 0.114 |
Other analgesics | 356 (15.1) | 116 (18.3) | 0.052 | 0.082 |
Steroids | 51 (2.2) | 19 (3.0) | 0.220 | 0.049 |
Preoperative Laboratory Data | ||||
Anemia | 618 (26.3) | 147 (23.2) | 0.115 | 0.073 |
Thrombocytopenia/normal/ thrombocytosis | 85/2142/126 (3.6/91.0/5.4) | 19/590/25 (3.0/93.1/3.9) | 0.255 | 0.077 |
Leukopenia/normal/leukocytosis | 89/2198/66 (3.8/93.4/2.8) | 22/598/14 (3.5/94.3/2.2) | 0.657 | 0.042 |
Hyponatremia/normal/hypernatremia | 26/2279/48 (1.1/96.9/2.0) | 10/611/13 (1.6/96.4/2.1) | 0.626 | 0.041 |
Hemoglobin (g/dL) | 12.7 ± 1.1 | 12.8 ± 1.1 | 0.111 | 0.071 |
C-reactive protein (mg/dL) | 0.23 ± 0.48 | 0.21 ± 0.4 | 0.014 | 0.052 |
Aspartate aminotransferase (IU/L) | 23.0 ± 8.9 | 22.4 ± 9.0 | 0.008 | 0.064 |
Alanine aminotransferse (IU/L) | 19.9 ± 11.2 | 20.4 ± 12.0 | 0.569 | 0.039 |
Albumin (g/dL) | 3.9 ± 0.3 | 3.8 ± 0.3 | <0.001 | 0.418 |
Uric acid (mg/dL) | 4.6 ± 1.2 | 4.6 ± 1.1 | 0.519 | 0.029 |
Abnormality on echocardiogram | 279 (11.9) | 48 (7.6) | 0.002 | 0.163 |
Abnormality on pulmonary function test | 103 (4.4) | 40 (6.4) | 0.041 | 0.081 |
Demographic Data | General (N = 467) | Spinal (N = 467) | Standardized Difference |
---|---|---|---|
Age | 69.4 ± 6.5 | 69.3 ± 6.4 | 0.011 |
Body mass index (kg/m2) | 26.4 ± 3.3 | 26.4 ± 3.3 | 0.017 |
Sex, Female/male | 423/44 (90.6/9.4) | 416/51 (89.1/10.9) | 0.049 |
ASA PS †, 1/2/3 | 17/425/25 (3.6/91.0/5.4) | 18/426/23 (3.9/91.2/4.9) | 0.022 |
Smoking HistoryNon/current/ex-smoker | 340/15/112 (72.8/3.2/24.0) | 320/18/129 (68.5/3.9/27.6) | 0.094 |
Surgical Data | |||
Surgical strategy, Single/staggered/staged_1st/staged_2nd/simultaneous | 238/120/19/27/63 (51.0/25.7/4.1/5.8/13.5) | 240/110/23/31/63 (51.4/23.6/4.9/6.6/13.5) | 0.069 |
Surgeon, B/C/K | 216/208/43 (46.3/44.5/9.2) | 204/228/35 (43.7/48.8/7.5) | 0.095 |
Preoperative Medical History | |||
Diabetes mellitus | 74 (15.9) | 70 (15.0) | 0.023 |
Hypertension | 166 (35.6) | 170 (36.4) | 0.017 |
Ischemic heart disease | 47 (10.1) | 45 (9.6) | 0.014 |
Cerebrovascular disease | 29 (6.2) | 30 (6.4) | 0.008 |
Pulmonary disease | 26 (5.6) | 27 (5.8) | 0.009 |
Adrenal disease | 7 (1.5) | 6 (1.3) | 0.020 |
Preoperative Medication History | |||
Calcium channel blocker | 186 (39.8) | 178 (38.1) | 0.035 |
Angiotensin converting enzyme inhibitor | 165 (35.3) | 162 (34.7) | 0.014 |
Beta blocker | 84 (18.0) | 77 (16.5) | 0.040 |
Aspirin | 101 (21.6) | 99 (21.2) | 0.010 |
Clopidogrel | 42 (9.0) | 39 (8.4) | 0.022 |
HMG-CoA reductase inhibitors ‡ | 160 (34.3) | 150 (32.1) | 0.044 |
Antibiotics | 0 (0) | 1 (0.2) | 0.054 |
NSAIDs | 29 (6.2) | 24 (5.1) | 0.048 |
Selective cyclooxygenase-2 inhibitor | 102 (21.8) | 101 (21.6) | 0.005 |
Other analgesics | 94 (20.1) | 81 (17.3) | 0.072 |
Steroids | 13 (2.8) | 11 (2.4) | 0.025 |
Preoperative Laboratory Data | |||
Anemia | 119 (25.5) | 106 (22.7) | 0.066 |
Thrombocytopenia/normal/thrombocytosis | 18/427/22 (3.9/91.4/4.7) | 17/431/19 (3.6/92.3/4.1) | 0.034 |
Leukopenia/normal/leukocytosis | 25/432/10 (5.4/92.5/2.1) | 21/437/9 (4.5/93.6/1.9) | 0.043 |
Hyponatremia/normal/hypernatremia | 7/450/10 (1.5/96.4/2.1) | 4/455/8 (0.9/97.4/1.7) | 0.068 |
Hemoglobin (g/dL) | 12.7 ± 1.2 | 12.8 ± 1.1 | 0.088 |
C-reactive protein (mg/dL) | 0.22 ± 0.38 | 0.23 ± 0.45 | 0.008 |
Aspartate aminotransferase (IU/L) | 22.2 ± 7.7 | 22.6 ± 9.6 | 0.048 |
Alanine aminotransferse (IU/L) | 20.4 ± 12.2 | 20.5 ± 12.9 | 0.010 |
Albumin (g/dL) | 3.8 ± 0.3 | 3.8 ± 0.3 | 0.085 |
Uric acid (mg/dL) | 4.7 ± 1.2 | 4.7 ± 1.1 | 0.003 |
Abnormality on echocardiogram | 49 (10.5) | 45 (9.6) | 0.032 |
Abnormality on pulmonary function test | 34 (7.3) | 34 (7.3) | 0.0 |
Intraoperative Data | Total Set | Matched Set | ||||
---|---|---|---|---|---|---|
General Group (n = 2353) | Spinal Group (n = 634) | p-Value | General Group (n = 467) | Spinal Group (n = 467) | p-Value | |
Use of vasopressor | 430 (18.3) | 102 (16.1) | 0.202 | 77 (16.5) | 86 (18.4) | 0.432 |
Use of calcium channel blocker | 366 (15.6) | 58 (9.2) | <0.001 | 65 (13.9) | 34 (7.3) | 0.001 |
Use of beta blocker | 516 (21.9) | 8 (1.3) | <0.001 | 95 (20.3) | 5 (1.1) | <0.001 |
Red blood cell transfusion | 795 (33.8) | 103 (16.3) | <0.001 | 95 (20.3) | 99 (21.2) | 0.730 |
Infused crystalloid (mL) | 1014.8 ± 600.1 | 961.1 ± 551.2 | 0.016 | 922.4 ± 574.1 | 1013.5 ± 599.9 | 0.012 |
Infused colloid (mL) | 544.6 ± 305.1 | 382.8 ± 209.0 | <0.001 | 496.7 ± 277.9 | 402.0 ± 215.0 | <0.001 |
Urine output (mL) | 193.4 ± 230.8 | 379.4 ± 350.6 | <0.001 | 168.0 ± 209.9 | 366.2 ± 341.8 | <0.001 |
The lowest mean blood pressure (mm Hg) | 69.3 ± 8.5 | 73.1 ± 9.8 | <0.001 | 70.3 ± 8.7 | 72.6 ± 9.9 | <0.001 |
Operation time (minute) | 133.4 ± 42.3 | 122.5 ± 33.8 | <0.001 | 123.7 ± 34.8 | 124.4 ± 36.9 | 0.731 |
Tourniquet time (minute) | 123.1 ± 34.5 | 105.3 ±30.6 | <0.001 | 114.0 ± 31.0 | 104.5 ± 31.0 | <0.001 |
Clinical Outcome | Group | Total Set | Matched Set | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Event | Odds Ratio | 95% Confidence Interval | p-Value | Event | Odds Ratio | 95% Confidence Interval | p-Value | ||||
Acute kidney injury | General | 143 | 1 | 24 | |||||||
Spinal | 19 | 0.477 | 0.293 | 0.778 | 0.003 | 13 | 0.529 | 0.273 | 1.024 | 0.059 | |
Cardiovascular complication | General | 29 | 1 | 10 | |||||||
Spinal | 7 | 0.895 | 0.390 | 2.052 | 0.793 | 5 | 0.495 | 0.166 | 1.470 | 0.205 | |
Pulmonary complication | General | 38 | 14 | ||||||||
Spinal | 7 | 0.680 | 0.276 | 1.676 | 0.402 | 4 | 0.280 | 0.091 | 0.862 | 0.027 | |
Deep vein thrombosis/Pulmonary thromboembolism | General | 28 | 11 | ||||||||
Spinal | 3 | 0.395 | 0.119 | 1.309 | 0.129 | 2 | 0.178 | 0.039 | 0.813 | 0.026 | |
Delirium | General | 32 | 7 | ||||||||
Spinal | 19 | 2.241 | 1.254 | 4.004 | 0.006 | 15 | 2.181 | 0.873 | 5.450 | 0.095 | |
Neurologic complication | General | 18 | 3 | ||||||||
Spinal | 6 | 1.239 | 0.490 | 3.133 | 0.650 | 6 | 2.013 | 0.497 | 8.146 | 0.327 | |
Surgical site infection | General | 14 | 4 | ||||||||
Spinal | 6 | 1.596 | 0.611 | 4.171 | 0.340 | 6 | 1.507 | 0.420 | 5.409 | 0.530 | |
Gastrointestinal complication | General | 58 | 6 | ||||||||
Spinal | 26 | 1.692 | 1.060 | 2.701 | 0.028 | 14 | 2.375 | 0.943 | 5.980 | 0.066 | |
Endocrinologic complication | General | 3 | 2 | ||||||||
Spinal | 1 | 1.237 | 0.128 | 11.918 | 0.854 | 1 | 0.499 | 0.045 | 5.540 | 0.571 | |
Urologic complication | General | 24 | 11 | ||||||||
Spinal | 9 | 1.397 | 0.641 | 3.048 | 0.400 | 4 | 0.358 | 0.122 | 1.053 | 0.062 | |
Major complication | General | 70 | 18 | ||||||||
Spinal | 24 | 1.283 | 0.800 | 2.058 | 0.301 | 22 | 1.233 | 0.654 | 2.325 | 0.517 | |
Intensive care unit admission | General | 59 | 1 | 15 | |||||||
Spinal | 21 | 1.332 | 0.803 | 2.210 | 0.267 | 19 | 1.278 | 0.647 | 2.526 | 0.480 |
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Kim, H.-J.; Park, H.-S.; Go, Y.-J.; Koh, W.U.; Kim, H.; Song, J.-G.; Ro, Y.-J. Effect of Anesthetic Technique on the Occurrence of Acute Kidney Injury after Total Knee Arthroplasty. J. Clin. Med. 2019, 8, 778. https://doi.org/10.3390/jcm8060778
Kim H-J, Park H-S, Go Y-J, Koh WU, Kim H, Song J-G, Ro Y-J. Effect of Anesthetic Technique on the Occurrence of Acute Kidney Injury after Total Knee Arthroplasty. Journal of Clinical Medicine. 2019; 8(6):778. https://doi.org/10.3390/jcm8060778
Chicago/Turabian StyleKim, Ha-Jung, Hee-Sun Park, Yon-Ji Go, Won Uk Koh, Hyungtae Kim, Jun-Gol Song, and Young-Jin Ro. 2019. "Effect of Anesthetic Technique on the Occurrence of Acute Kidney Injury after Total Knee Arthroplasty" Journal of Clinical Medicine 8, no. 6: 778. https://doi.org/10.3390/jcm8060778