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爱尔兰初次全髋关节置换术后患者自报并发症发生率:事实还是虚构。

Self-reported complication rates following primary total hip arthroplasty in Ireland: fact or fiction.

机构信息

Department of Elective Orthopaedics, The Adelaide and Meath Incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland.

出版信息

Ir J Med Sci. 2011 Mar;180(1):167-71. doi: 10.1007/s11845-010-0576-1. Epub 2010 Oct 10.

Abstract

BACKGROUND

There are little data available on complication rates following primary total hip arthroplasty (THA) surgery in Ireland.

AIMS

To determine self-reported complication rates and national data for primary THA.

METHODS

A postal questionnaire surveyed Irish orthopaedic association consultant members. Additional data were obtained from the economic and social research institute (ESRI).

RESULTS

We achieved an 83% response rate. 5,424 THAs were self-reported. Mean dislocation rates were 1%, but higher using a posterior surgical approach (p < 0.05). Mean deep infection rates were 0.4%. 29% were MRSA. No reduction was reported from additional barrier prophylaxes. Mean venous thrombo-embolism (VTE) rates were 3.5%. No reduction was reported from commencing prophylaxis preoperatively or extending treatment duration. National rates for dislocation, deep infection and VTE were 25.7, 0.87, and <0.1%, respectively.

CONCLUSIONS

The creation of a National Hip Register is strongly recommended. A register would improve surgical practices and patient outcomes, and provide significant healthcare savings.

摘要

背景

在爱尔兰,关于初次全髋关节置换术(THA)后并发症发生率的数据较少。

目的

确定初次 THA 的自报告并发症发生率和全国数据。

方法

通过邮寄问卷对爱尔兰骨科协会顾问成员进行调查。还从经济和社会研究所(ESRI)获得了额外的数据。

结果

我们的回复率达到了 83%。报告了 5424 例 THA。脱位的平均发生率为 1%,但后路手术入路的发生率更高(p<0.05)。深部感染的平均发生率为 0.4%。29%为耐甲氧西林金黄色葡萄球菌(MRSA)。额外的屏障预防措施并没有减少感染率。静脉血栓栓塞(VTE)的平均发生率为 3.5%。从术前开始预防或延长治疗时间并没有减少 VTE 的发生率。全国范围内的脱位、深部感染和 VTE 的发生率分别为 25.7%、0.87%和<0.1%。

结论

强烈建议建立国家髋关节登记处。登记处将改善手术实践和患者结局,并提供显著的医疗保健节省。

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