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术前季节性疫苗接种与整关节整形术后的并发症之间的关联
George Bcharah1, Austin E Wininger1, Zaid Elsabbagh2
1Department of Orthopaedic Surgery, Mayo Clinic, Phoenix, Arizona.
在全关节整形手术 (TJA) 之前接种COVID-19疫苗可能会降低肺炎和周围假肢关节感染 (PJI) 的风险. 然而,最近的流感疫苗接种与TJA后的深静脉血栓症 (DVT) 和PJI等并发症增加有关.
科学领域:
- 整形外科 整形外科 整形外科
- 传染病流行病学 传染病流行病学
- 疫苗学 疫苗学 疫苗学
背景情况:
- 呼吸道疫苗接种很常见,但它们对全关节整形术 (TJA) 结果的影响尚不清楚.
- 调查疫苗的时间和类型对于TJA后的患者安全至关重要.
研究的目的:
- 检查术前和术后流感和COVID-19疫苗接种和TJA结果之间的关联.
- 为了确定与TJA相关的疫苗接种时间的潜在风险或益处.
主要方法:
- 一项大型国家注册研究包括595,339名成年TJA患者.
- 患者按流感疫苗接种 (手术前) 和COVID-19疫苗接种 (手术前或后) 分组.
- 倾向性得分匹配对混因子进行控制;结果包括修订,感染,松,骨折,并发症和死亡率.
主要成果:
- 在TJA后3个月内接种流感疫苗与90天内增加的医学并发症 (DVT,肺炎) 和4年PJI相关.
- 在TJA后3个月内接种COVID-19疫苗显示,90天肺炎的发病率降低.
- 在TJA之前随时接种COVID-19疫苗与较低的PJI率 (2-4年) 和较低的4年全因复查率有关.
结论:
- 在TJA前的COVID-19疫苗接种与改善的结果有关,包括减少肺炎和PJI.
- 最近的流感疫苗接种可能与不良的TJA结果有关,包括较高的PJI和DVT率.
- 结果表明疫苗类型和时间影响TJA的成功,但因果关系需要进一步研究.
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