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Ann Rheum Dis:类风湿关节炎全髋或膝关节成形术后的修复、假体关节感染和死亡率的预测指标

2017-11-03 xiangting MedSci原创

与THA/TKA后的OA患者相比,RA患者的10年修复风险降低,而死亡风险和PJI风险升高。

这项研究在以下人群中探讨了全髋/全膝关节成形术(THA/TKA)后10年修复风险和1年假体关节感染PJI)风险的预测指标:(1)类风湿关节炎(RA)患者与骨关节炎(OA)患者比较; (2)与未治疗的患者相比,在手术前90天内用生物性疾病改善抗风湿药(bDMARD)治疗的RA患者。

研究人员使用丹麦国家患者登记、DANBIO风湿病登记(RA特异性混杂因素和治疗集)和丹麦髋关节和膝关节成形术登记进行基于登记的队列研究。使用生存分析来计算混杂因素调整的亚HRsHRR)和HRs

总共有3913例进行THA/TKARA患者与120 499OA患者进行比较。RA患者修复的风险降低(SHR 0.710.57-0.89)),但PJI风险(SHR = 1.461.13-1.88))和死亡风险升高(HR = 1.251.01-1.55))。在DANBIO中,1946例进行THA/TKARA患者中有345例在手术前90天内接受了bDMARD治疗。与非治疗组相比,bDMARD治疗组患者的修复风险(SHR = 1.490.65-3.40)),PJISHR = 1.610.70-3.69))和死亡风险均没有显著升高(HR = 0.750.24-2.33))。糖皮质激素暴露(HR = 2.871.12-7.34))和升高的DAS28HR = 1.491.01-2.20))是死亡率的危险因素。

THA/TKA后的OA患者相比,RA患者的10年修复风险降低,而死亡风险和PJI风险升高。在这项研究中,使用bDMARDPJI或死亡的风险显著升高无相关性。糖皮质激素暴露和疾病活动性增加与死亡风险升高相关。

原始出处:

Rene Lindholm Cordtz, et al. Predictors of revision, prosthetic joint infection and mortality following total hip or total knee arthroplasty in patients with rheumatoid arthritis: a nationwide cohort study using Danish healthcare registers. Ann Rheum Dis. 02 November 2017.

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

 

 

 

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    2017-11-05 lmm397
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