Dy Christopher J, Daluiski Aaron, Do Huong T, Hernandez-Soria Alexia, Marx Robert, Lyman Stephen
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
J Hand Surg Am. 2012 May;37(5):919-24. doi: 10.1016/j.jhsa.2012.02.003. Epub 2012 Mar 28.
To describe the incidence of reoperation and the demographic factors that may be associated with reoperation after flexor tendon repair.
Using a New York statewide hospital administrative database covering an 8-year period, we examined unique patient discharges with an index procedure of flexor tendon repair for reoperation (re-repair or tenolysis). We compared the age, sex, race, and insurance type by reoperation status using standard univariate statistics and multivariate regression analysis. We performed trend analysis using the Cochran-Armitage trend test.
From 1998 to 2005, there were 5,229 flexor tendon repairs with a frequency of reoperation of 6%; of these, 91% were in the first year after the primary procedure. Those who underwent reoperation were significantly older than those who did not undergo reoperation. Patients with workers' compensation were 63% more likely to undergo reoperation than those with other forms of insurance. Patients who had concomitant nerve repair during the index procedure were 26% less likely to undergo reoperation. The rate of reoperation did not change during the study period.
These results may be useful in shaping research agendas to evaluate sociodemographic factors contributing to reoperations.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.
描述屈指肌腱修复术后再次手术的发生率以及可能与再次手术相关的人口统计学因素。
利用纽约州全州范围的医院管理数据库，该数据库涵盖8年时间，我们检查了以屈指肌腱修复作为初次手术进行再次手术（再次修复或肌腱松解术）的独特患者出院情况。我们使用标准单变量统计和多变量回归分析，按再次手术状态比较年龄、性别、种族和保险类型。我们使用 Cochr an - Armitage趋势检验进行趋势分析。
1998年至2005年，共进行了5229例屈指肌腱修复术，再次手术发生率为6%；其中，91%发生在初次手术后的第一年。接受再次手术的患者明显比未接受再次手术的患者年龄大。获得工伤赔偿的患者再次手术的可能性比其他形式保险的患者高63%。在初次手术期间同时进行神经修复的患者再次手术的可能性降低26%。在研究期间，再次手术率没有变化。
这些结果可能有助于制定研究议程，以评估导致再次手术的社会人口统计学因素。
研究类型/证据水平：预后II级。
