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Objective <p>To identify the risk factors for cardiovascular complications following lower limb joint replacement surgery in elderly patients and to develop a risk assessment tool for clinical application to validate its efficacy.</p> Methods <p>A retrospective analysis was conducted on 405 elderly patients (aged ≥ 65 years) who underwent lower limb joint replacement surgery at a hospital between January 2017 and December 2022. Statistically significant variables identified through univariate analysis were incorporated into a non-conditional binary logistic regression model for further analysis. The effectiveness of the logistic regression model was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC). Based on the regression model, a risk assessment tool for cardiovascular complications post-surgery was established and clinically applied from February to July 2023 to determine criteria for identifying high-risk patients based on sensitivity and specificity.</p> Results <p>Among the 405 patients in the retrospective study, 32 (7.90%) experienced cardiovascular complications postoperatively. Logistic regression analysis indicated that age (OR 1.98, 95% CI 1.15–3.43), body mass index (BMI) (OR 2.80, 95% CI 1.28–6.16), preoperative lipoprotein (a) (OR 1.97, 95% CI 0.90–4.35), ASA classification (OR 3.57, 95% CI 1.14–11.18), and anesthesia&#xa0;method (OR 0.36, 95% CI 0.18–0.71) were independent risk factors for cardiovascular complications in this population (<i>P</i> &lt; 0.05). The AUC was 0.773, with a 95% confidence interval of (0.684–0.861). In the clinical application of the risk assessment tool, 5 out of 83 patients (6.02%) developed cardiovascular complications post-surgery, indicating that patients with preoperative scores exceeding 6.5 and total postoperative scores exceeding 8.5 had a significantly higher risk of complications.</p> Conclusion <p>This preliminary study elucidated the risk factors for cardiovascular complications following lower limb joint replacement surgery in elderly patients and established a risk assessment tool that demonstrated promising&#xa0;results in initial clinical application. Further validation in larger, multi-center studies is needed before widespread implementation.</p>

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Analysis of risk factors and clinical application of cardiovascular complications following lower limb joint replacement surgery in elderly patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月25日

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  • Huaxing Zhang,
  • Jingjing Cao,
  • Jingde Jia,
  • Jia Chen

摘要

Objective

To identify the risk factors for cardiovascular complications following lower limb joint replacement surgery in elderly patients and to develop a risk assessment tool for clinical application to validate its efficacy.

Methods

A retrospective analysis was conducted on 405 elderly patients (aged ≥ 65 years) who underwent lower limb joint replacement surgery at a hospital between January 2017 and December 2022. Statistically significant variables identified through univariate analysis were incorporated into a non-conditional binary logistic regression model for further analysis. The effectiveness of the logistic regression model was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC). Based on the regression model, a risk assessment tool for cardiovascular complications post-surgery was established and clinically applied from February to July 2023 to determine criteria for identifying high-risk patients based on sensitivity and specificity.

Results

Among the 405 patients in the retrospective study, 32 (7.90%) experienced cardiovascular complications postoperatively. Logistic regression analysis indicated that age (OR 1.98, 95% CI 1.15–3.43), body mass index (BMI) (OR 2.80, 95% CI 1.28–6.16), preoperative lipoprotein (a) (OR 1.97, 95% CI 0.90–4.35), ASA classification (OR 3.57, 95% CI 1.14–11.18), and anesthesia method (OR 0.36, 95% CI 0.18–0.71) were independent risk factors for cardiovascular complications in this population (P < 0.05). The AUC was 0.773, with a 95% confidence interval of (0.684–0.861). In the clinical application of the risk assessment tool, 5 out of 83 patients (6.02%) developed cardiovascular complications post-surgery, indicating that patients with preoperative scores exceeding 6.5 and total postoperative scores exceeding 8.5 had a significantly higher risk of complications.

Conclusion

This preliminary study elucidated the risk factors for cardiovascular complications following lower limb joint replacement surgery in elderly patients and established a risk assessment tool that demonstrated promising results in initial clinical application. Further validation in larger, multi-center studies is needed before widespread implementation.