在接受关节整形手术的透析依赖患者中,过度风险和资源利用:来自全国代表性数据库的见解
David Maman1,2, Yaniv Steinfeld1,2, Yaron Berkovich1,2
1Rappaport Faculty of Medicine, Technion University Hospital (Israel Institute of Technology), Haifa, Israel.
Frontiers in surgery
|February 2, 2026
概括
在透析患者的关节整形术 (THA) 显著增加死亡率,住院时间和医院费用. 加强术后护理对于接受THA的高危人群至关重要.
科学领域:
- 整形外科手术 整形外科手术
- 腎臟病學 (nephrology) 是一種醫學.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 全关节整形术 (THA) 是治疗末期关节疾病的常见手术.
- 在透析中患有末期病 (ESRD) 的患者面临THA并发症的风险更高.
- 对于透析依赖的THA患者的风险调整后果存在有限的数据.
研究的目的:
- 评估透析依赖对THA后外科手术后结果的影响.
- 为了比较透析依赖和独立的THA患者之间的住院死亡率,住院时间,住院费用和并发症率.
主要方法:
- 使用全国性住院患者样本 (2016-2022) 的回顾性队列研究.
- 透析依赖性通过ICD-10-CM代码Z99.2.2.9确定透析依赖性
- 10:1倾向性得分匹配用于平衡患者特征.
- 使用风险比率 (RR) 分析结果,使用95%的置信区间 (CI).
主要成果:
- 在THA患者中,0.1% (2,730/1,957,284) 的患者存在透析依赖.
- 透析依赖的患者在医院内死亡率明显高 (匹配RR:10.1).
- 与较长的LOS (62.5%的增长),更高的医院费用 (95.8%的增长) 和更多的重大并发症有关.
结论:
- 透析依赖是THA后不良结果的独立预测因素.
- 透析患者的患病率,死亡率和成本大幅增加.
- 多学科优化和增强的外科手术周边路径对于这一群体至关重要.
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