Preoperative risk stratification reduces the incidence of perioperative complications after total knee arthroplasty.

The purpose of this study was to validate a screening and management protocol to identify and reduce risk of renal, pulmonary, and delirium complications. A cohort study comparing incidence of perioperative complications on a consecutive series of patients undergoing total knee arthroplasty with a historical control group was conducted. The study cohort was evaluated prospectively to identify and reduce noncardiac medical complications. Medical records were reviewed for in-hospital complications. There were 623 patients in the study cohort and 493 patients in the control population. There was a statistically significant decrease in the incidence of delirium (control, 10.4% vs study, 0.8%; P = .0001), renal (4.9% vs 0.6%, P = .0001), cardiac (16.3% vs 2.1%, P = .0001), and pulmonary complications (5.7% vs 0.8%, P = .0001) in the screened patients vs control. Preoperative screening and management for medical complications resulted in a significant decrease in renal, pulmonary, delirium, and cardiac complications.