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J Arthroplasty:翻修关节置换术患者的再入院风险因素研究

2016-03-27 Seven L MedSci原创

近期发表在J Arthroplasty的研究,对翻修关节置换术患者的再入院和延长住院时间的危险因素进行了探究。研究人员对美国外科医师学会全国外科质量改进计划数据库进行了回顾性分析,纳入了4977名接受翻修膝关节置换术,5135名接受翻修髋关节置换术的患者。研究人员使用国际疾病分类,第九版修订诊断编码,对机械问题、松动、感染、脱位或骨折进行分类。研究人员对再入院和非再入院患者的人口统计资料、合并症、

近期发表在J Arthroplasty的研究,对翻修关节置换术患者的再入院和延长住院时间的危险因素进行了探究。

研究人员对美国外科医师学会全国外科质量改进计划数据库进行了回顾性分析,纳入了4977名接受翻修膝关节置换术,5135名接受翻修髋关节置换术的患者。研究人员使用国际疾病分类,第九版修订诊断编码,对机械问题、松动、感染、脱位或骨折进行分类。

研究人员对再入院和非再入院患者的人口统计资料、合并症、术中的变量、出院前情况和术后30天的预后进行了比较。使用多元逻辑回归模型对出院前严重或轻微的不良事件进行评估,并对翻修手术进行预测。

研究结果表明,翻修术最常见的原因是机械问题和松动,其次为感染,接着是错位。研究人员发现,再入院和非再入院患者相比,出院前严重或轻微的不良事件发生率显著更高。

多变量分析结果显示,出院前严重不良事件、肺部疾病、卒中、心脏疾病、男性和美国麻醉医师(ASA)分为3或4级是再入院的预测因素。无论是髋关节还是膝关节组,手术并发症是进行翻修术最常见的原因。

此外多因素分析还显示,机械松动、功能状态、BMI高、糖尿病和心脏病是延长住院时间的独立预测因子。其他独立因素还包括卒中、出血相关性疾病、ASA分为3或4级,还有吸烟史。

原始出处:

Keswani A, et al. Risk Factors Predict Increased Length of Stay and Readmission Rates in Revision Joint Arthroplasty.J Arthroplasty.2016;doi:10.1016/j.arth.2015.09.050.

Study highlights risk factors of readmission, longer stay after revision joint arthroplasty
.Healio.March 22, 2016

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    2016-07-16 yxch48
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    2016-04-13 Wechat4343a314

    翻修术复杂困难併发症多,麻醉风险大。

    0

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    2016-03-29 zhaojie88
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    2016-03-28 1de304d2m86(暂无匿称)

    值得学习

    0

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