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加快关节骨折手术时间的好处根据患者的风险概况而异

Abhishek Ganta^1,2, Lauren A Merrell¹, Carolyn Herbosa¹

¹Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and.

Journal of orthopaedic trauma

|November 27, 2024

概括

加快关节骨折手术改善了高风险患者的治疗结果. 低风险患者在48小时内手术时与24小时后手术时的结果没有差异.

科学领域:

整形外科手术整形外科手术
老年医学老年医学
创伤护理创伤护理

背景情况:

部骨折在老年人中很常见,手术时间会影响结果.
风险分层工具可以帮助个性化治疗关节骨折患者.

研究的目的:

根据患者风险分层,确定手术性关节骨折修复的最佳时间.
确定特定的患者群体,他们最受益于早期手术干预.

主要方法:

对2472名患有AO/OTA 31A,31B或32A骨折的患者进行了回顾性队列研究.
用经过验证的风险工具将患者分为四个风险四分位数 (IRQ).
包括并发症,死亡率和医院质量指标在内的结果基于手术前的时间 (<24,24-48,>48小时) 进行了分析.

主要成果:

总的来说,24小时内进行的手术与晚期手术相比,结果有所改善 (P<0.050).
高风险患者 (IRQ4) 经历了延迟手术的主要并发症和死亡率的增加 (分别P = 0.007和P = 0.006).
低风险患者 (IRQ1) 在不同手术时间组的结果中没有显著差异 (P = 0.756).

结论:

对于关节骨折的手术时间有根据患者风险分层的差异性影响.
低风险的关节骨折患者如果在48小时内进行手术,与24小时相比,结果不会更差.

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