Xu G G, Sathappan S S, Jaipaul J, Chan Siew Pang, Lai Choon Hin
Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore.
Ann Acad Med Singap. 2008 Nov;37(11):924-8.
A total knee arthroplasty (TKA) clinical pathway database has been used in our institution since the year 2000. The primary aim of this study was to review the patient epidemiology, postoperative complications and factors influencing hospital length of stay following TKA. The clinical outcomes and cost-savings between elective and same day admissions for TKA patients were also reviewed.
The study cohort retrieved from the database comprised 1,371 patients (1,663 knees) who underwent total knee replacement over a 6-year time period. The following variables were reviewed: epidemiological data, admission data (elective admission [EA] versus same day admission [SDA]), hospital length of stay (LOS), and complication rates.
The mean age of patients undergoing TKA is 65.2 years (range, 22 to 90). Osteoarthritis was the main surgical indication in 96% of the study cohort. Overall, there was a gradual decline in the hospital length of stay for the study cohort for the 6-year time period. The overall complication rate was 2% and the 3 most common complications were deep vein thrombosis, pulmonary embolism and urinary tract infection.
With an increasing elderly population there will be an annual increase in the number of TKAs. In our local population TKAs are performed primarily for the Chinese female in the 7th decade. The overall complication rate of TKA remains low with a mortality rate of <1%.
自2000年起，我院开始使用全膝关节置换术（TKA）临床路径数据库。本研究的主要目的是回顾TKA术后患者的流行病学特征、并发症及影响住院时间的因素。同时，还对TKA患者择期入院和当日入院的临床结局及成本节约情况进行了回顾。
从数据库中检索出的研究队列包括1371例患者（1663个膝关节），这些患者在6年时间内接受了全膝关节置换术。对以下变量进行了回顾：流行病学数据、入院数据（择期入院[EA]与当日入院[SDA]）、住院时间（LOS）和并发症发生率。
接受TKA患者的平均年龄为65.2岁（范围为22至90岁）。骨关节炎是96%研究队列的主要手术指征。总体而言，研究队列在6年期间的住院时间呈逐渐下降趋势。总体并发症发生率为2%，3种最常见的并发症为深静脉血栓形成、肺栓塞和尿路感染。
随着老年人口的增加，TKA的数量将逐年增加。在我们当地人群中，TKA主要针对70岁左右的中国女性进行。TKA的总体并发症发生率仍然较低，死亡率<1%。
