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膝关节整形术和无家可归:一个数据库研究

Terrul Ratcliff1,2, Anubhav Thapaliya2, Patrick Ojeaga1

  • 1Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

The archives of bone and joint surgery
|September 15, 2025
PubMed
概括

接受全膝关节整形手术 (TKA) 的无家可归患者面临着明显更高的术后并发症风险,包括感染和失血. 这凸显了需要专业护理,以改善这个弱势群体的结果.

关键词:
复杂性 复杂性 复杂性无家可归 没有家可归膝盖 膝盖 膝盖 膝盖 在整体膝关节关节整形手术易受伤害的人口群体

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科学领域:

  • 整形外科手术 整形外科手术
  • 公共卫生 公共卫生
  • 健康差异 在健康上的差异

背景情况:

  • 在美国,无家可归影响了55万多人,患病率和平均年龄都在上升.
  • 这种人群经历了更高的慢性疾病负担,增加了对不良健康结果的脆弱性.
  • 膝关节整形术 (TKA) 是常见的,但无家可归患者的结果需要特别调查,因为担心并发症的增加.

研究的目的:

  • 为了比较无家可归患者和接受初级全膝关节整形手术 (TKA) 的非无家可归患者之间的术后并发症率.

主要方法:

  • 使用TriNetX研究网络数据库进行回顾性队列研究.
  • 确定了245567名初级TKA患者 (CPT 27447),使用ICD-9/10代码将463人归类为无家可归者.
  • 分析了人口统计学变量和术后并发症,计算了几率比率 (OR),并使用了奇平方/费舍尔的精确测试.

主要成果:

  • 无家可归患者更有可能是老年人,肥胖者,糖尿病患者和吸烟者.
  • 在无家可归患者中观察到更高的表面手术部位感染率 (OR 7.52),假肢关节感染率 (OR 2.70),急性功能衰竭 (OR 2.44),失血性贫血 (OR 2.25) 和肺栓塞 (OR 2.81).
  • 对于所有报告的并发症增加率,发现了统计学意义 (p<0.008).

结论:

  • 与非无家可归者相比,接受TKA的无家可归患者经历了明显更高的多次术后并发症的风险.
  • 这些发现强调了针对性手术前优化策略的关键需求.
  • 量身定制的术后护理计划对于减轻风险和改善这种脆弱患者群体的外科治疗结果至关重要.