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比较常见的风险评估工具来预测膝关节关节整形术的结果

Travis M Kotzur¹, Aaron Singh¹, Lindsey N Peng¹

¹Department of Orthopaedic Surgery, UT Health San Antonio, San Antonio, Texas.

The Journal of arthroplasty

|February 9, 2024

概括

与查尔森并发症指数 (CCI) 和医院虚弱风险评分 (HFR) 相比,埃利克沙瑟并发症指数 (ECI) 最好预测膝关节整形术 (TKA) 患者的30天术后结果. 外科医生应该在TKA中使用ECI进行手术前风险评估.

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
医疗信息学医疗信息学

背景情况:

风险评估工具,如查尔森共同发病率指数 (CCI),埃利克沙瑟共同发病率指数 (ECI) 和医院脆弱性风险评分 (HFR),用于手术风险评估.
风险评估的最佳工具,特别是在选择性手术中,如全关节形术,仍在争论中.
准确的手术前风险评估对于优化全膝关节整形术 (TKA) 患者的结果至关重要.

研究的目的:

为了比较CCI,ECI和HFR对TKA患者各种术后结果的预测准确度.
确定对接受全膝关节关节整形手术的患者最有效的风险评估工具.
为TKA中术前风险分层提供基于证据的建议.

主要方法:

从国家再接收数据库 (2016-2019) 中使用ICD-10代码对TKA患者的回顾性分析.
收集患者人口统计数据,术后并发症和与医院相关的结果.
利用接收器操作特征 (ROC) 曲线和曲线下的面积 (AUC) 来评估CCI,ECI和HFR的预测性能.

主要成果:

分析包括1,930,803名TKA患者.
在多个结局中,ECI表现出卓越的预测能力:死亡率 (0.95 AUC),周围假肢骨折 (0.78 AUC),关节感染 (0.78 AUC),30天再入院 (0.79 AUC) 和30天重复手术 (0.69 AUC).
与ECI相比,CCI和HFR显示所有评估结果的AUC明显较低.

结论:

埃利克沙瑟并发症指数 (ECI) 是预测膝关节整形术后30天术后结果的最有效工具.
在这个患者群体中,ECI的表现优于查尔森并发症指数 (CCI) 和医院脆弱性风险评分 (HFR).
使用ECI进行手术前风险评估建议外科医生进行TKA,以改善患者管理和结果.

关键词:

关节整形术并发症关节整形术并发症这种疾病是共患的.脆弱脆弱脆弱脆弱脆弱膝关节关节整形手术膝关节关节整形手术风险评估风险评估风险评估

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