在TKA中,手术时间与与肥胖相关的结果有关吗?
Maveric K I L Abella1,2, John P M Angeles1,3, Andrea K Finlay1
1Stanford University, Department of Orthopaedic Surgery, Stanford, CA, USA.
Clinical orthopaedics and related research
|October 11, 2023
概括
手术时间,不仅仅是肥胖,影响了全膝关节整形术 (TKA) 的并发症. 专注于手术复杂性而不是仅仅重量可以改善肥胖患者获得TKA的机会.
科学领域:
- 整形外科手术 整形外科手术
- 生物统计学 生物统计学
- 患者研究成果研究结果
背景情况:
- 全膝关节整形手术 (TKA) 的基于肥胖的标准可能会不必要地限制某些患者的入口.
- 手术时间,作为手术复杂性的衡量标准,可能是术后并发症的更重要的预测因素,而不仅仅是身体质量指数 (BMI).
研究的目的:
- 为了确定手术时间是否与BMI类独立,与TKA后的再入院,再手术和并发症有关.
- 调查手术时间是否会改变肥胖和不良术后结果之间的关系.
主要方法:
- 来自美国外科医生学院国家外科质量改进计划数据库 (2014-2020) 的379,993个可选单边TKA的分析.
- 多变量逻辑回归模型根据BMI类,年龄,性别,种族,吸烟状况和并发症进行调整.
- 对手术时间和BMI类对30天结果的相互作用效应的评估.
主要成果:
- 较长的手术时间独立地与重新入院,重新手术和大/小并发症的几率增加有关.
- 对于每增加30分钟的手术时间,再入院的几率增加了9%,重复手术的几率增加了15%,重大并发症增加了9%,轻微并发症增加了18%.
- 肥胖与在较短的手术时间中重新手术的几率较低,但在更长的时间内更高的几率相关.
结论:
- 手术时间是影响TKA结果的关键因素,根据肥胖状况有不同的影响.
- 关于肥胖患者的TKA的决定应该考虑整体的外科复杂性,而不仅仅是体重.
- 未来的研究应该确定患者特异性的因素,有助于改进手术策略和改善TKA结果的手术时间.
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