Evidence map›Paper›PMID 36611176›Full record

ArticleBMC musculoskeletal disorders2023

The impact of dehydration on short-term postoperative complications in total knee arthroplasty.

Brandon Lung, Kylie Callan, Maddison McLellan, Matthew Kim, Justin Yi, William McMaster, Steven Yang, David So

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC musculoskeletal disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
3.2field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Role of Perioperative Fluid Resuscitation in Same-Day Total Joint Arthroplasty Discharge at a Level 1 Academic Center.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025
    Article
  4. Dehydration independently predicts prolonged hospital stay following aseptic revision total shoulder arthroplasty.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
    Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Brandon LungDepartment of Orthopaedic Surgery, University of California, Irvine, 101 The City Dr S Pavilion 3, CA, 92868, Orange, USA. blung@hs.uci.edu.
Kylie CallanDepartment of Orthopaedic Surgery, University of California, Irvine, 101 The City Dr S Pavilion 3, CA, 92868, Orange, USA.
Maddison McLellanDepartment of Orthopaedic Surgery, University of California, Irvine, 101 The City Dr S Pavilion 3, CA, 92868, Orange, USA.
Matthew KimDepartment of Orthopaedic Surgery, Stony Brook University School of Medicine, NY, Stony Brook, USA.
Justin YiDepartment of Orthopaedic Surgery, University of California, Irvine, 101 The City Dr S Pavilion 3, CA, 92868, Orange, USA.
William McMasterDepartment of Orthopaedic Surgery, University of California, Irvine, 101 The City Dr S Pavilion 3, CA, 92868, Orange, USA.
Steven YangDepartment of Orthopaedic Surgery, University of California, Irvine, 101 The City Dr S Pavilion 3, CA, 92868, Orange, USA.
David SoDepartment of Orthopaedic Surgery, University of California, Irvine, 101 The City Dr S Pavilion 3, CA, 92868, Orange, USA.
University of California, Irvine · USStony Brook University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAs healthcare economics shifts towards outcomes-based bundled payment models, providers must understand the evolving dynamics of medical optimization and fluid resuscitation prior to elective surgery. Dehydration is an overlooked modifiable risk factor that should be optimized prior to elective total knee arthroplasty (TKA) to reduce postoperative complications and inpatient costs.

methodsAll primary TKA from 2005 to 2019 were queried from the National Surgical Quality Improvement Program (NSQIP) database, and patients were compared based on dehydration status: Blood Urea Nitrogen Creatinine ratio (BUN/Cr) < 20 (non-dehydrated), 20 ≤ BUN/Cr ≤ 25 (moderately-dehydrated), 25 < BUN/Cr (severely-dehydrated). A sub-group analysis involving only elderly patients > 65 years and normalized gender-adjusted Cr values was also performed.

resultsThe analysis included 344,744 patients who underwent TKA. Adjusted multivariate logistic regression analysis showed that the severely dehydrated cohort had a greater risk of non-home discharge, postoperative transfusion, postoperative deep vein thrombosis (DVT), and increased length of stay (LOS) (all p < 0.01). Among the elderly, dehydrated patients had a greater risk of non-home discharge, progressive renal insufficiency, urinary tract infection (UTI), postoperative transfusion, and extended LOS (all p < 0.01).

conclusionBUN/Cr > 20 is an important preoperative diagnostic tool to identify at-risk dehydrated patients. Providers should optimize dehydration to prevent complications, decrease costs, and improve discharge planning. LEVEL OF EVIDENCE: Level III; Retrospective Case-Control Design; Prognosis Study.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeAgedDehydrationHumansLength of StayPostoperative ComplicationsRetrospective StudiesRisk FactorsBUN/Cr rationDehydration statusKnee arthroplastyNSQIPPostoperative complications

Identifiers

PMID36611176
PMCPMC9825029
OpenAlexW4313644034

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.