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Patient-related risk factors for postoperative mortality and periprosthetic joint infection in medicare patients undergoing TKA
Bozic KJ, Lau E, Kurtz S, Ong K, Berry DJ.. Clinical orthopaedics and related research, 2012-01-01
Topic: Risk, prevention and care in population studies
Background The impact of specific baseline comorbid conditions on the relative risk of postoperative mortality and periprosthetic joint infection (PJI) in elderly patients undergoing TKA has not been well defined. Questions/purposes We calculated the relative risk of postoperative mortality and PJI associated with 29 comorbid conditions in Medicare patients undergoing TKA. Patients and methods The Medicare 5% sample was used to calculate the relative risk of 90-day postoperative mortality and PJI as a function of 29 preexisting comorbid conditions in 83,011 patients who underwent primary TKA between 1998 and 2007. Results The independent risk factors for 90-day postoperative mortality (in decreasing order of significance) were congestive heart failure, metastatic cancer, renal disease, peripheral vascular disease, cerebrovascular disease, lymphoma, cardiac arrhythmia, dementia, pulmonary circulation disorders, and chronic liver disease. The independent risk factors for PJI (in decreasing order of significance) were congestive heart failure, chronic pulmonary disease, preoperative anemia, diabetes, depression, renal disease, pulmonary circulation disorders, obesity, rheumatologic disease, psychoses, metastatic tumor, peripheral vascular disease, and valvular disease. Conclusions We believe this information important when counseling elderly patients regarding the risks of mortality and PJI after TKA and risk-adjusting publicly reported TKA patient outcomes.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Bozic, K. J., Lau, E., Kurtz, S., Ong, K., & Berry, D. J. (2012). Patient-related risk factors for postoperative mortality and periprosthetic joint infection in medicare patients undergoing TKA. Clinical orthopaedics and related research. https://doi.org/10.1007/s11999-011-2043-3
Vancouver
Bozic KJ, Lau E, Kurtz S, Ong K, Berry DJ. Patient-related risk factors for postoperative mortality and periprosthetic joint infection in medicare patients undergoing TKA. Clinical orthopaedics and related research. 2012. doi:10.1007/s11999-011-2043-3. PMID: 21874391.
BibTeX
@article{bozic2012-21874391,
author = {Bozic, K. J. and Lau, E. and Kurtz, S. and Ong, K. and Berry, D. J.},
title = {{Patient-related risk factors for postoperative mortality and periprosthetic joint infection in medicare patients undergoing TKA}},
journal = {Clinical orthopaedics and related research},
year = {2012},
doi = {10.1007/s11999-011-2043-3},
pmid = {21874391},
url = {https://doi.org/10.1007/s11999-011-2043-3}
}
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Key findings
- Questions/purposes We calculated the relative risk of postoperative mortality and PJI associated with 29 comorbid conditions in Medicare patients undergoing TKA.
- Results The independent risk factors for 90-day postoperative mortality (in decreasing order of significance) were congestive heart failure, metastatic cancer, renal disease, peripheral vascular disease, cerebrovascular disease, lymphoma, cardiac arrhythmia, dementia, pulmonary circulation disorders, and chronic liver disease.
Why it matters
This study of Medicare patients having knee replacement found that dementia was among the conditions linked to higher risk of death within 90 days after surgery. It is about surgical risk in people who already have dementia, not about treating, curing or preventing Alzheimer's disease.
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Study details
- Participants83,011
- Evidence strengthLow
How this study scored 55/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Clinical orthopaedics and related research) |
| Journal's citation record | 3 / 4 | Clinical Orthopaedics and Related Research: journal h-index 350 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2012 — within 20 year(s) of the newest study here |
| Sample size | 4 / 4 | 83,011 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 418 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 26.1 citations a year over 16 year(s) since 2012 |
| Impact for its field and year | 4 / 6 | Cited 14.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 3 / 4 | Cited 75 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Daniel J. Berry: h-index 97 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of California, San Francisco: institution h-index 1,915 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 21874391) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 55 / 100 | — |
What each of these 20 components measures, and what this score is not →
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