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手术后关节疼痛与全关节形术后的长期全因死亡率有关

Ming Liu¹, Andrew Furey², Proton Rahman³

¹Human Genetics & Genomics, Division of Biomedical Sciences, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.

|July 3, 2025

概括

在全关节整形术 (TJA) 后的术后关节疼痛可以预测长期死亡率. 具体来说,活跃时经历疼痛显著增加了TJA患者的死亡风险,独立于其他健康因素.

科学领域:

整形外科整形外科整形外科
老年学是一门学科.
公共卫生公共卫生

背景情况:

手术后关节疼痛是整体关节整形术 (TJA) 后的一个常见问题.
经过TJA持续疼痛的长期预后影响需要进一步调查.
了解疼痛对死亡率的影响对于患者的管理和结果至关重要.

研究的目的:

为了确定术后关节疼痛是否预测TJA患者的长期全因死亡率.
调查不同类型的术后关节疼痛与TJA接受者的死亡原因 (COD) 之间的关联.

主要方法:

一组727名接受全膝盖或关节整形手术的患者在手术后至少一年使用WOMAC疼痛分级来评估术后关节疼痛.
疼痛被分为"持续疼痛"",活跃时疼痛"和"休息时疼痛",没有疼痛作为对照组.
使用卡普兰-梅尔生存分析和多变量考克斯回归来评估疼痛和死亡率之间的关联,并对共变量进行调整. 费舍尔的精确测试比较了COD分布.

主要成果:

在TJA后4年,持续疼痛,活跃疼痛和静止疼痛的患病率分别为10%,17%和12%.
在TJA后11年,所有原因的死亡率分别为20%,26%,19%和15%持续疼痛,活跃疼痛,休息疼痛和对照组.
在调整年龄,性别,BMI,心血管疾病和癌症后,活跃时的疼痛与死亡率增加显著相关 (HR ≥2.57,p <0.001). 没有发现疼痛与特定死亡原因之间的联系.

结论:

手术后的关节疼痛,特别是活动期间的疼痛,是经过全关节整形手术的患者长期全因死亡率的重要预测因素.
这些发现强调了治疗和管理术后关节疼痛的重要性,以潜在地改善TJA患者的长期生存结果.
进一步的研究可能会探索连接持续关节疼痛与增加死亡风险的潜在机制.

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