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在手术前出现异常白细胞计数和在全肩关节整形术后出现的术后并发症
Kenny Ling1, Nicholas Tsouris2, Matthew Kim1
1Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.
JSES international
|July 10, 2023
概括
不正常的手术前白细胞计数预测了全肩关节整形术 (TSA) 后的并发症. 白血病会增加深静脉血栓形成的风险,而白血细胞形成与肺炎,肺栓塞和败血症有关.
科学领域:
- 整形外科手术 整形外科手术
- 血液学 血液学 血液学
- 患者安全 患者安全
背景情况:
- 全肩关节整形术 (TSA) 是肩部关节炎和骨折的首要治疗方法.
- 越来越多的TSA需求需要改进手术前风险评估.
- 手术前白细胞计数和TSA并发症之间的联系还未得到充分研究.
研究的目的:
- 为了调查异常的手术前白细胞计数和TSA后的30天术后并发症之间的关联.
主要方法:
- 利用美国外科医生学院国家外科质量改进计划数据库 (2015-2020).
- 分析了23341名接受TSA治疗的患者的数据.
- 采用多变量逻辑回归来确定白血病/白血细胞病与并发症之间的关联.
主要成果:
- 手术前的白血病与增加的输血出血和深静脉血栓症有关.
- 手术前白细胞瘤与较高的肺炎,肺栓塞,流血输血,败血症,败血性休克,再入院和非家庭出院率有关.
- 在对患者变量进行控制后,这些关联仍然显著.
结论:
- 术前白血病独立预测TSA后30天的深静脉血栓形成风险.
- 手术前白血球症独立预测多种严重并发症,包括感染和心血管事件,在TSA后30天内.
- 异常的手术前白细胞计数对于风险分层有价值,以尽量减少TSA并发症.
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