C. 在TKA发生前6个月内发生严重感染与短期并发症增加有关
Oliver C Sax1, Scott J Douglas1, Zhongming Chen1
1Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, LifeBridge Health, Baltimore, Maryland.
The journal of knee surgery
|July 21, 2023
概括
在全膝关节整形手术 (TKA) 之前有Clostridium difficile感染 (CDI) 的病史会增加术后并发症和再入院的风险. 推在CDI后推迟TKA,特别是在六个月内,以获得更好的患者结果.
科学领域:
- 整形外科手术 整形外科手术
- 传染性疾病 传染性疾病
- 医疗保健服务研究 医疗服务研究
背景情况:
- 艰难杆菌感染 (CDI) 病史可能表明患者健康状况不佳,膝关节全关节整形术 (TKA) 后并发症风险较高.
- 了解TKA前CDI定时对术后结果的影响对于患者管理至关重要.
研究的目的:
- 为了比较90天术后CDI,并发症和重新入院的频率,在有和没有TKA前CDI病史的患者中进行.
- 根据之前的CDI与TKA相比的时间来确定与术后结果相关的风险因素.
主要方法:
- 一个全国性的全付费者数据库被用来识别在2010年至2019年期间接受初级TKA的患者.
- 患有TKA前CDI的患者 (n=7,195) 被分为两组:CDI>6个月前 (n=6,027) 和CDI ≤6个月前 (n=1,168).
- 这些组与140万没有CDI病史的患者进行了比较,这些患者使用了奇平方测试和未调整的几率比率.
主要成果:
- 之前的CDI,无论时间如何,都与术后CDI的几率明显增加有关.
- 在TKA之前CDI≤6个月的患者患上术后并发症和再入院的几率最高 (OR59.05).
- 其他并发症,如年龄,肥胖,吸烟和使用抗生素与术后CDI无关.
结论:
- 在TKA之前的CDI与术后CDI的几率增加有关.
- 最近的CDI (≤6个月前) 构成TKA后手术后并发症和再入院的最大风险.
- 应考虑在CDI后推迟TKA,以允许患者康复和感染清除.
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