在全关节整形术后输血的风险:一项针对367,894名患者的国家数据库研究
Felipe Gonzalez Gutierrez1, Joshua Sun1, Senthil Sambandam1
1University of Texas Southwestern, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
Journal of orthopaedics
|November 23, 2023
概括
在全关节整形术 (THA) 后输血不常见 (3.6%). 关键的危险因素包括状细胞病,肝硬化和透析,增加输血的可能性. 男性性别和非选择性入学也会增加风险.
科学领域:
- 整形外科手术 整形外科手术
- 输血医学 输血医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 美国人口老龄化和外科手术的进步增加了关节整形术 (THA) 率.
- 血输后的THA与不良结果有关,需要识别危险因素.
- 了解这些风险对于改善患者安全和治疗结果至关重要.
研究的目的:
- 为了确定与THA后输血率增加相关的并发症.
- 分析影响THA后输血必要性的人口和临床因素.
- 为有针对性的干预提供数据,以减少THA患者输血风险.
主要方法:
- 使用了2016-2019年全国住院患者样本 (NIS) 数据库.
- 包括接受THA的患者,分为"输血"和"不输血"组.
- 进行多变量分析以确定输血的独立风险因素.
主要成果:
- 在367,894名THA患者中,3.5%接受了输血.
- 状细胞病 (OR 4.81),肝硬化 (OR 3.02) 和透析 (OR 2.22) 显著增加了输血几率.
- 男性性别 (OR 1.99) 增加了几率,而高加索族裔 (OR 0.65) 减少了几率;选择性入学减少了几率 (OR 0.283).
结论:
- 输血后的THA发生在3.6%的病例中.
- 与输血风险增加相关的重大并发症包括状细胞病,肝硬化,透析,SLE和心脏病.
- 输血组的死亡率和非选择性入院率较高.
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