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在喘患者的全膝关节整形术后发生不良事件的风险
Julian Smith-Voudouris1, Lee E Rubin, Jonathan N Grauer
1From the Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT.
The Journal of the American Academy of Orthopaedic Surgeons
|April 24, 2024
概括
接受全膝关节整形术 (TKA) 的喘患者面临更高的不良事件和5年修订风险. 喘严重程度与并发症几率的增加相关,因此需要为这些人量身定制的风险管理策略.
科学领域:
- 整形外科手术 整形外科手术
- 肺部病理学 肺部病理学
- 流行病学 流行病学
背景情况:
- 膝盖全关节整形术 (TKA) 是一种普遍的手术程序.
- 患者特异性因素显著影响TKA的术后结果.
- 喘是一种常见的炎症性呼吸道疾病,尽管与骨关节炎有关,但与TKA结局有关的研究尚未广泛进行.
研究的目的:
- 调查TKA后喘和术后结果之间的关联.
- 为了比较TKA患有喘和没有喘的患者的不良事件发生率和修订率.
- 分析喘严重程度对TKA结局的影响.
主要方法:
- 从2015年到2021年,使用PearlDiver数据对成年TKA患者进行了回顾性分析.
- 喘患者与非喘患者根据年龄,性别和Elixhauser并发症指数 (ECI) 进行1:1匹配.
- 使用多变量逻辑回归来比较90天的不良事件和5年修订,用喘严重程度分层进行进一步分析.
主要成果:
- 在721,686名TKA患者中有10.5%患有喘.
- 喘患者的90天肺部,非肺部和总体不良事件的几率增加,包括急诊室的访问.
- 在喘患者中观察到5年修订的概率是1.17倍,所有严重程度的风险都增加,随着严重程度的增加而增加.
结论:
- 喘在TKA患者中是一个显著的并发症,与更高的不良事件和长期修订的可能性有关.
- 在TKA后出现并发症的风险随着喘严重程度的增加而升级.
- 对于接受TKA的喘患者来说,具体的风险减轻策略至关重要.
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