Perioperative medicine & outcomes
Cardiometabolic disease and obesity patterns differentially predict acute kidney injury after total joint replacement: a retrospective analysis
Authors' conclusion
The current study suggests that the co-occurrence of metabolic conditions (diabetes mellitus, hypertension), with or without obesity, is a more important risk factor for acute kidney injury than individual comorbid diseases.
Study context
- Population
- Patients ≥18 years undergoing primary total knee or hip arthroplasty, US Multicenter Perioperative Outcomes Group hospitals, 2008–2019
- Participants
- 81,639 patients
- Exposure
- Latent class/obesity interaction groups vs 'hypertension only'/non-obese
- Hypertension onlyn = 37,223
- Metabolic syndrome (MetS)n = 36,503
- MetS+CVDn = 7,913
- Outcome
- Any postoperative AKI (modified KDIGO criteria)
Methodological detailsmulticentre, latent class analysis, mixed-effects logistic regression
- Multicentre
- Latent class analysis
- Mixed-effects logistic regression
Main finding
As reported in the abstract
Odds of AKI by latent class/obesity group (adjusted)
Each group vs hypertension only/non-obeseOdds (fold increase) (95% CI)
Hypertension only/obese
1.7(1.5–2.0)
Each group vs hypertension only/non-obeseOdds ratio (95% CI)
MetS+CVD/obesehighest odds
3.1(2.6–3.7)
- MetS+CVD/non-obese
- odds (times) 2.2 (95% CI 1.8–2.7)
- Model AUC
- 0.76
Observational data: associations, not effects.
Further findings
Acute kidney injury (AKI) incidence (overall)
- Developed AKI
- 4007 (4.9%)
Characteristics of patients with AKI
- More commonly older and non-Hispanic Black, with more significant comorbidity
Original publication
Cardiometabolic disease and obesity patterns differentially predict acute kidney injury after total joint replacement: a retrospective analysis. Br J Anaesth. Published 13 May 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →