在全膝关节整形手术之前的患者指定:手术前的变量如何影响手术后的状态?
Jeremiah Thomas1, Thomas Bieganowski1, Mary Carmody1
1Department of Orthopedic Surgery, NYU Langone Health, New York, New York.
The Journal of arthroplasty
|August 17, 2023
概括
许多全膝关节整形术 (TKA) 患者在术后转换为住院患者 (IP). 高龄,女性性别,晚期手术开始时间,肥胖和较高的并发症得分预测转化,影响门诊TKA规划.
科学领域:
- 整形外科手术 整形外科手术
- 医疗保健服务研究 医疗服务研究
- 患者的治疗结果.
背景情况:
- 在从仅限住院患者名单中删除后,向门诊全膝关节整形术 (TKA) 的转变需要了解风险人群的结果.
- 门诊 (OP) TKA模型对患有术后并发症风险较高的患者群体的影响尚不清楚.
研究的目的:
- 研究从OP转换为住院 (IP) 状态对TKA术后结果的影响.
- 为了确定患者特异性和术后因素,预测TKA后从OP转换为IP状态.
主要方法:
- 对2,313名原始TKA患者的回顾性审查,最初计划进行OP手术.
- 使用多重回归和二进制物流回归来分析周围操作变量,以确定OP到IP状态转换的预测因素.
主要成果:
- 27.1%的最初OP TKA患者需要IP停留 (≥2个午夜).
- 专业知识产权转换与明显更高的设施放电率有关.
- 转换的预测因素包括年龄较大 (≥65岁),女性性别,晚些时候到达麻醉后护理单位 (下午12点后),肥胖 (BMI>30) 和较高的查尔森并发症指数 (≥4).
- 作为当天的第一个手术病例和结婚是防止依的保护因素.
结论:
- 患者内在因素可能会使个体在TKA后处于IP停留状态.
- 了解这些诱导因素对于优化术后规划和管理向门诊TKA模型过渡至关重要.
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