关节骨折患者的并发症和感染风险:一项基于丹麦人口的队列研究
N R Gadgaard1, C Varnum2,3, R G H H Nelissen4
1Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Olof Palmes Allé 43, 8200, Aarhus, Denmark. nrg@clin.au.dk.
概括
并发症显著增加了部骨折患者的感染风险,直至手术后的一年. 较高的并发症水平与较高的感染率相关,需要加强手术前后护理计划.
科学领域:
- 整形外科手术 整形外科手术
- 传染病流行病学 传染病流行病学
- 老年医学 老年医学
背景情况:
- 在老年关节骨折患者中观察到越来越多的并发症和感染率.
- 同病症对关节骨折后感染风险的确切影响尚不清楚.
- 这项研究调查了并发症负担和感染发病率之间的关联.
研究的目的:
- 根据他们的并发症水平,检查骨折患者感染的绝对和相对风险.
- 量化不同并发症水平对手术后长达一年的感染发病率的影响.
- 为高风险患者制定有针对性的干预措施提供信息.
主要方法:
- 一项使用丹麦国家卫生登记册的队列研究.
- 包括92,600名65岁以上的接受关节骨折手术的患者 (2004-2018).
- 使用查尔森并发症指数 (CCI) 评估并发症;结果包括各种医院治疗的感染和败血症.
主要成果:
- 40%的患者有中度 (CCI 1-2) 和19%的患者有严重 (CCI ≥3) 的并发症.
- 随着伴随性疾病的增加,感染发病率增加:严重伴随性疾病患者在30天内感染风险为20%,在365天内感染风险为37%.
- 对于任何在医院治疗的感染,严重并发症的调整危险比率 (aHR) 为1.6 (0-30天) 和1.9 (0-365天);败血症风险最高 (aHR为2.7在0-365天内).
结论:
- 伴随性疾病是部骨折手术后感染的重要和独立的风险因素.
- 手术后多达一年的感染风险仍然存在,特别是在患有严重并发症的患者中.
- 改进的手术前后管理策略对于减轻关节骨折患者的感染风险至关重要.
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