Basilico et al identified risk factors for cardiovascular complications in patients undergoing total joint replacement surgery. These can help identify a patient who may benefit from more aggressive management or a change in the surgical approach. The authors are from New England Baptist Hospital and Brigham and Women's Hospital in Boston.


Patient selection: total joint replacement


Risk factors for cardiovascular complications:

(1) older age (age > 75 years)

(2) history of arrhythmias

(3) history of other cardiac disorders (heart failure, AMI, valvular disease, etc)

(4) bilateral joint replacements

(5) revision surgery



• The adjusted odds ratios range from 1.6 to 3.5 (average 2.3).

• A history of beta-blocker use can be substituted for the history of cardiac disease)


The risk of a cardiovascular complications increases with the number of risk factors identified.


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