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与选择性全关节置换术相比,关节骨折手术后的结果

Yannick Le Manach¹, Gary Collins², Mohit Bhandari³

¹Department of Anesthesia, Michael DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada2Department of Clinical Epidemiology and Biostatistics, Michael DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada3Popula.

|September 16, 2015

概括

与选择性全关节置换 (THR) 相比,关节骨折手术显著增加了住院死亡率和重大并发症的风险. 即使根据年龄,性别和相关疾病进行调整,这种风险仍然很高.

科学领域:

骨科手术
老年医学
公共卫生

背景情况:

接受关节骨折手术的患者死亡率和并发症率高于选择性全关节置换 (THR) 的患者.
晚年和并发症对骨骨折患者术后风险增加的具体影响尚不清楚.

研究的目的:

为了比较关节骨折手术和选择性关节骨折手术之间的住院死亡率.
在此比较中调整年龄,性别和手术前的并发症.

主要方法:

使用法国国家医院出院数据库 (2010-2013) 对45岁以上接受关节手术的患者.
使用国际疾病分类第10版 (ICD-10) 代码来识别相关疾病和并发症.
使用多变量后勤模型和年龄,性别和并发症的贪匹配算法创建匹配队列 (1:1比率).

主要成果:

包括690,995名患者;319,804人接受了关节骨折手术,371,191人接受了选择性THR手术.
与选择性THR相比,关节骨折手术患者的住院死亡率 (3. 42% 与 0. 18%) 和重大术后并发症 (5. 88% 与 2. 34%) 较高.
匹配分析证实骨折手术的死亡率显著增加 (RR 5. 88) 和严重并发症 (RR 2. 50).

结论:

与选择性THR相比,部骨折手术与住院死亡的风险相对较高,即使考虑到关键的患者因素.
这些发现突出了与关节骨折手术相关的重大外科风险.
需要进一步研究以阐明这些观察到的结果差异的具体原因.

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