慢性抗凝药与术后并发症的风险增加有关,在无菌修复后,全关节整形术
Kevin Y Heo1, Rahul K Goel2, Andrew Fuqua1
1Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia.
The Journal of arthroplasty
|January 18, 2024
概括
慢性抗凝药 (AC) 治疗的患者在修复整部关节整形术 (rTHA) 后面临更高的并发症风险. 这包括感染率增加和机械问题,需要仔细的患者咨询.
科学领域:
- 整形外科手术 整形外科手术
- 关节质整术是指关节质整术.
- 患者安全 患者安全
背景情况:
- 由于人口老龄化,修订关节整形术 (rTHA) 的数量正在增加.
- 慢性抗凝血 (AC) 与初级THA的并发症有关,但其对rTHA的影响不太清楚.
研究的目的:
- 为了比较慢性AC和非AC患者在无菌rTHA中的术后并发症率.
主要方法:
- 对接受无菌rTHA (2014-2019) 的9421名患者的回顾性分析.
- 两个队列:慢性AC (n=1,790) 和没有慢性AC (n=7,631).
- 90天和2年的并发症的比较,控制共变量.
主要成果:
- 慢性AC患者患90天假肢关节感染 (PJI) (OR 3.2),手术部位感染 (OR 3.6) 和机械并发症 (OR 3.5) 的几率更高.
- 在2年后,慢性AC患者的PJI (OR 3.3) 和机械并发症 (OR 3.2) 的几率增加.
- 慢性AC患者在2年内重新手术的几率更高 (OR1.9).
结论:
- 在无菌rTHA后,慢性AC患者经历了显著更高的90天和2年的并发症率.
- 增加的风险包括PJI,手术部位感染和机械假肢问题.
- 对接受rTHA的AC患者来说,关于风险-益处的多学科咨询至关重要.
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