Background: Although previous studies evaluated postoperative outcomes of arthroplasty patients with chronic obstructive pulmonary disease (COPD), no meta-analysis has been conducted.
Methods: An electronic search was conducted on PubMed, Embase, and Cochrane Library databases to identify relevant studies published from inception to May 1, 2022. To assess the impact of COPD on postoperative outcomes, the odds ratios and 95% confidence intervals were calculated; pooled results were calculated using a random effects model. Sensitivity and subgroup analyses were carried out according to surgical type and statistical method. A total of 11 retrospective cohort studies involving patients with COPD who underwent hip or knee arthroplasties were included in the meta-analysis. There were 195,444 patients with COPD and 1,592,908 patients without COPD.
Results: A pooled analysis showed that the COPD group was at higher risk for mortality, readmission, pneumonia, sepsis, septic shock, and surgical site infection within 30 days following hip arthroplasties than the non-COPD group. Moreover, COPD patients were more likely to experience mortality, readmission, pneumonia, sepsis, septic shock, and surgical site infection 30 days after knee arthroplasties.
Conclusion: In this study, coexisting COPD was associated with worse outcomes in patients with lower extremity joint arthroplasties. The findings highlighted the importance of preoperative optimization and proactive interventions for COPD in the perioperative period.
Keywords: chronic obstructive pulmonary disease; complication; joint arthroplasty; lower extremity; mortality; readmission.
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