Previous History of Breast Cancer Increases Rates of Pulmonary Embolism and Costs after Total Knee Arthroplasty: An Evaluation of 185,114 Matched Patients

Samuel Rosas; T. David Luo; Alexander H. Jinnah; Alejandro Marquez-Lara; Martin W. Roche; Cynthia L. Emory

doi:10.1055/s-0038-1641155

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2019; 32(04): 337-343
DOI: 10.1055/s-0038-1641155

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Previous History of Breast Cancer Increases Rates of Pulmonary Embolism and Costs after Total Knee Arthroplasty: An Evaluation of 185,114 Matched Patients

Samuel Rosas

¹Department of Orthopedic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina

,

T. David Luo

¹Department of Orthopedic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina

,

Alexander H. Jinnah

¹Department of Orthopedic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina

,

Alejandro Marquez-Lara

¹Department of Orthopedic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina

,

Martin W. Roche

²Department of Orthopedic Surgery, Holy Cross Orthopedic Institute, Fort Lauderdale, Florida

,

Cynthia L. Emory

¹Department of Orthopedic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina

› Author Affiliations

Abstract

Risk factors for adverse events after total knee arthroplasty (TKA) relating to malignancy have not been well studied. Thus, the purpose of this study was to conduct a retrospective case–control outcome and cost analysis after TKA in this population. Patients with a history of breast cancer (BrCa) were identified based on the International Classification of Disease 9th revision codes. An age- and sex-matched cohort was also identified of patients without a history of BrCa. Complications, length of stay, comorbidity burden, and reimbursements were tracked at 90 days. Each cohort comprised 92,557 patients. Length of stay was similar between cohorts (p = 0.627). Comorbidity status and incidence of pulmonary embolism (PE), lower extremity ultrasound, and chest computed tomography (CT) use were higher in patients with a history of BrCa (p < 0.05 for all). Control patients had a lower incidence of acute myocardial infarction (0.14 vs. 0.21%; p < 0.001). Surgical complications were similar. The 90-day reimbursements were greater in patients with a history of BrCa (US$13,990 vs. US$13,033 for controls; p = 0.021). Surgeons should be aware of the increased risk of PE after TKA in patients with a history of BrCa as well as increased 90-day costs, which warrant great attention.

Keywords

total knee arthroplasty - cancer - breast - outcomes - cost

Full Text

References

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