The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

Risk Factors and Outcomes Associated with Emergency Abdominal Surgery following Lower Extremity Total Joint Arthroplasty

Document Type : RESEARCH PAPER

Authors
Annie Lu
Senthil Sambandam
Marc Gadda
Terrul Ratcliff
Sergio Huerta
UT Southwestern Medical Center, Dallas, Texas, USA
10.22038/abjs.2024.82090.3743
Abstract
Objectives: This study aims to identify potential risk factors and assess postoperative outcomes 
associated with requiring emergency abdominal surgery (EAS) within 30 days following total hip 
arthroplasty (THA) and total knee arthroplasty (TKA). We hypothesized that patients requiring EAS 
would carry a higher morbidity and mortality rates compared to patients that underwent the index 
operation alone.
Methods: We conducted a retrospective analysis using TriNetX, examining data from 2016-2024 from patients over 
18 years old who underwent THA/TKA and required EAS within 30 days. Postoperative outcomes, including mortality 
and hospital readmission, were compared between patients requiring EAS and those who did not. Statistical 
analyses included measures of association and chi-squared tests. Patient demographic data, including age, sex, 
and comorbidities were analyzed.
Results: Patients requiring EAS within 30 days of a joint arthroplasty were significantly more likely to be older, 
overweight or obese, and to be diagnosed with comorbidities including diverticular disease, cholelithiasis, alcohol 
use disorders, and tobacco use. These patients had significantly higher mortality rates within 60 days of joint 
arthroplasty compared to patients without EAS, suggesting that the second operation contributed significantly to the 
increase in adverse outcomes. 
Conclusion: This study emphasizes the importance of recognizing key risk factors for severe GI complications that 
require EAS. These findings highlight the need for careful patient selection, pre-operative evaluation of risk, and 
vigilant post-operative management, especially in those with many risk factors. Improved identification and 
management of high-risk patients may help reduce the likelihood of EAS and its associated mortality.
 Level of evidence: IIIArthroplasty, Emergency abdominal surgery, Mortality, Risk factors 
Keywords
Arthroplasty
Emergency abdominal surgery
Mortality
Risk factors
Subjects
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The Archives of Bone and Joint Surgery
Volume 13, Issue 4
April 2025
Pages 196-203

  • Receive Date 04 October 2024
  • Revise Date 16 December 2024
  • Accept Date 25 December 2024