伴随性疾病与全膝关节关节整形术的关联 医疗保健利用率
William G ElNemer1, Myung-Jin Cha1, Eve R Glenn1
1Department of Orthopaedic Surgery, Johns Hopkins Hospital, Columbia, Maryland.
The Journal of arthroplasty
|December 1, 2024
概括
伴随性疾病显著增加了全膝关节整形术 (TKA) 后的医院费用,成本和住院时间. 解决诸如肺高血压和肥胖等疾病可以优化患者的治疗结果,并减少医疗保健资源的利用.
科学领域:
- 整形外科手术 整形外科手术
- 卫生经济学 卫生经济学
- 患者的治疗结果.
背景情况:
- 膝关节整形术 (TKA) 患者经常与晚年相关的并发症.
- 常见的并发病包括肥胖,高血压和癌症.
- 这些情况可能会影响医院费用 (HC),医院费用 (HCos) 和住院时间 (LOS).
研究的目的:
- 确定特异性并发症与TCA患者中HC,HCo和LOS的相关性.
- 识别TKA后最显著影响医疗保健资源利用率的并发症.
- 为优化患者护理协议和财务负担沟通提供数据.
主要方法:
- 对于初级TKA患者 (2012-2020年) 进行了国家数据库查询.
- 分析了30种并发症,使用埃利克豪泽指数.
- 匹配的队列分析与多变量回归控制的混因素.
主要成果:
- 体重减轻,贫血,凝血病和液体/电解质障碍显著增加了HC.
- 肺高血压,非转移性瘤,和肥胖增加了HCo.
- 大多数并发症,除了甲状腺功能低下症,增加了LOS;肺高血压和体重减轻显著增加了长期停留的几率.
结论:
- 特定的并发症在TKA后显著增加HC,HCo和LOS.
- 建议针对营养不良患者和肺高血压患者进行有针对性的优化计划.
- 可量化的数据可以帮助临床医生与患者讨论财务和恢复影响.
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