与初级和修复关节塑形术相关的不良心脏事件
Christian Puelacher1,2, Adrian Stuetzle3, Mario Morgenstern3,4
1Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
The bone & joint journal
|August 1, 2025
概括
与初级关节整形相比,对周围假肢关节感染 (PJI) 的修复手术显著增加了周围手术期间心肌损伤和心脏梗塞 (PMI),主要心脏不良事件 (MACE) 和死亡率的风险.
科学领域:
- 整形外科手术 整形外科手术
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
背景情况:
- 周围假肢关节感染 (PJI) 是关节置换手术后的一种严重并发症.
- 对PJI进行修复手术具有重大风险,但对术后心脏结果的具体影响需要详细分析.
研究的目的:
- 为了比较术前心肌损伤和心脏病发作 (PMI),主要心脏不良事件 (MACE) 和PJI修复,无菌修复和初级关节形成术之间的死亡率的风险.
- 确定与修复关节塑造相关的特定心血管风险,特别是在PJI的背景下.
主要方法:
- 根据BASEL-PMI研究的后期分析,包括673名接受初级或修复全关节整形手术的患者.
- 在手术前和手术后测量高灵敏度心脏托罗邦素T.
- 评估PMI,所有原因死亡率和120天后的MACE.
主要成果:
- 在PJI (35%) 和无菌修订 (21%) 的修订中,与初级关节整形手术 (12%) 相比,PMI的更高率被观察到.
- 在PJI修改 (9%) 和无菌修改 (4%) 和初级关节塑形手术 (2%) 中,所有原因的死亡率显著增加.
- 对PJI的修订也显示了MACE率的增加 (12%) 和PMI的概率增加了2.9倍.
结论:
- 修复关节整形,特别是PJI,与术后心脏并发症和死亡率的风险显著增加有关.
- 心血管风险分层和管理对于接受修复关节整形手术的患者至关重要,特别是那些患有PJI的患者.
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