风湿性关节炎患者的周围假肢关节感染与更高的并发症和死亡率有关
Lucio Cappelli Toledo de Araujo1,2, Anette Westerholt3, Amir N Sandiford4
1Department of Orthopaedic Surgery, ENDO Klinik Buch, Berlin, Germany. toledodearaujol@gmail.com.
Archives of orthopaedic and trauma surgery
|March 19, 2024
概括
在类风湿性关节炎 (RA) 患者中,周围假肢关节感染 (PJI) 的并发症和死亡率很高. 早期诊断和治疗对于这种脆弱人群的更好的结果至关重要.
科学领域:
- 整形外科手术 整形外科手术
- 类风湿病学 类风湿病学
- 传染性疾病 传染性疾病
背景情况:
- 周围假肢关节感染 (PJI) 是全面关节整形术 (TJA) 后的一种严重并发症.
- 有限的研究存在于PJI,特别是在类风湿性关节炎 (RA) 患者中,这些患者通常是脆弱和免疫受损的.
- 由于RA患者的独特生理挑战,了解RA患者的PJI至关重要.
研究的目的:
- 报告PJI类风湿性关节炎 (RA) 患者队列中的并发症和死亡率.
- 在RA的背景下临床描述患有PJI的患者.
主要方法:
- 从2003年到2020年,对患有PJI的RA患者的医疗和手术记录进行了回顾性审查.
- 根据病史,体检,炎症标志物 (CRP,prokalcitonin,WBC),关节愿望和培养物进行PJI诊断.
- 研究设计:第三级回顾性队列研究.
主要成果:
- 在53名RA患者 (平均年龄65岁) 中,治疗了54例PJI (49例慢性).
- 总体死亡率为18.9%,其中5例死亡直接归因于PJI.
- 葡萄球菌是最常见的病原体 (63%),其次是多微生物感染 (20.4%).
结论:
- 患有类风湿性关节炎 (RA) 的患者经历了周围假肢关节感染 (PJI),面临高死亡率和并发症.
- 延迟诊断和治疗可能会导致这些不良结果.
- 对于这一高风险患者群体,需要进一步的研究和优化管理策略.
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