在全关节假肢感染后死亡率的增加主要是由并发症引起的,而不是感染本身
Anders Persson1, Olof Sköldenberg2, Maziar Mohaddes3
1Karolinska Institutet, Department of Clinical Sciences at Danderyd Hospital, Stockholm. anders.persson@regionstockholm.se.
Acta orthopaedica
|September 27, 2023
概括
关节修复手术后的周围假肢关节感染 (PJI) 不会独立增加死亡风险. 在这些病例中,患者的并发症,而不是感染本身,是死亡的主要驱动因素.
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
- 流行病学 流行病学
背景情况:
- 周围假肢关节感染 (PJI) 是关节整形术后的一种严重并发症.
- PJI与增加的死亡率之间的关联仍然存在争议.
- 调查PJI作为死亡的独立风险因素至关重要.
研究的目的:
- 确定PJI是否是接受修复全关节整形手术 (THA) 的患者死亡的独立风险因素.
- 在全国范围的队列中分析与PJI相关的死亡风险.
主要方法:
- 从1998年至2017年使用瑞典关节整形注册表 (SHAR) 的回顾性队列研究.
- 包括修订THA的患者,将PJI患者与无菌修订患者进行比较.
- 使用了考克斯的比例危险模型,根据年龄,性别,诊断和埃利克沙瑟并发症指数进行调整.
主要成果:
- 分析包括4943次PJI修订和12529次无菌修订,随访时间中位数为4.1年.
- 对于PJI的原始危险比为1.19,但对死亡率的调整后危险比为1.05 (CI 0.99-1.12).
- 患者的并发症成为最重要的混因素.
结论:
- 在PJI修订后观察到的高死亡风险主要归因于患者的并发症.
- 而PJI本身并不是该群体死亡率增加的独立预测指标.
- 在评估PJI患者的死亡风险时,并发症评估至关重要.
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