Study finds, Preventing Acute Kidney Injury and Hypotension
This body created a plan to manage and improve outcomes for all THA and TKA patients, based on pre- and postoperative risk factors associated with the development of acute kidney damage (AKI). This report illustrates the protocol's ongoing success and growth to reduce AKI and hypotension in patients with elective total arthroplasty.

A multidisciplinary team comprising orthopaedic surgeons, nephrologists, anesthesiologists, cardiologists, and internal medicine hospitalists created a comprehensive protocol aimed at decreasing complications after elective joint arthroplasty and improving clinical outcomes across multiple hospitals. Patient demographics, hospital length of stay, readmission rates, mortality, and postoperative AKI and hypotension incidences were recorded and compared between preprotocol phase I (initial protocol implementation) and phase II (protocol expansion across 10 hospitals) patient cohorts.

--Overall, 3,222 patients over 56 months and 10 hospitals were included.

--Our phase II AKI rate (0.6%) was significantly lower than our preprotocol rate (6.2%) and statistically similar to our phase I rate (1.2%).

--Our hypotension rate in phase II (6.8%) was significantly lower than our preprotocol rate (12.7%) but statistically similar to our phase I rate (5.9%).

--Furthermore, a significant decrease was observed in hospital length of stay over time, but no difference was observed in readmission and mortality rates over time.

This study provides a multidisciplinary, thorough and successful approach for managing and reducing AKI and hypotension rates in a wide range of patient groups across various hospital centres.