[翻译文章] 假肢关节感染风险因素的系统审查概述
M Sabater-Martos1, J C Martínez-Pastor1, A Morales2
1Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínic de Barcelona, Barcelona, Spain.
Revista espanola de cirugia ortopedica y traumatologia
|June 26, 2023
概括
对假肢关节感染风险因素的系统审查 (SRs) 显示了很大的重叠和方法差距. 证据质量较差,强调需要对可修改因素 (如皮质类固醇使用) 进行改进的研究.
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
- 基于证据的医学是基于证据的医学.
背景情况:
- 假肢关节感染 (PJI) 是一种严重的骨科并发症.
- 预测系统审查 (SRs) 旨在预测PJI风险并指导预防.
- 现有的SR具有方法上的局限性和知识上的差距.
研究的目的:
- 概述和综合SRs对PJI风险因素的证据.
- 评估包含的SRs的偏差风险和方法质量.
- 确定经常研究和相关的PJI风险因素.
主要方法:
- 在 4 个数据库 (截至 2021 年 5 月) 进行 PJI 风险因子预后性 SR 的文献搜索.
- 使用ROBIS工具进行偏差风险评估.
- 使用修改后的AMSTAR-2工具进行方法质量评估.
- 包含的SRs之间的研究重叠的分析.
主要成果:
- 23个SR确定了15个PJI风险因素,其中13个显示出显著的关联.
- 肥胖,关节内皮质类固醇,吸烟和不受控制的糖尿病是最受研究的.
- 在关键风险因素中发现了高至非常高的重叠,表明了冗余性.
- 只有34.7%的SR报告中报告了偏差的低风险,发现了显著的方法差距.
结论:
- 程序可修改的因素,如关节内皮质类固醇的使用,对于患者的治疗结果至关重要.
- 高SR重叠表明冗余,需要更专注的研究.
- 对PJI风险因素的总体证据基础因偏见的高风险和有限的方法质量而受到削弱.
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