Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
J Arthroplasty. 2012 Sep;27(8 Suppl):77-80.e1-8. doi: 10.1016/j.arth.2012.03.026. Epub 2012 Jun 6.
The purpose of this study was to validate a screening and management protocol to identify and reduce risk of renal, pulmonary, and delirium complications. A cohort study comparing incidence of perioperative complications on a consecutive series of patients undergoing total knee arthroplasty with a historical control group was conducted. The study cohort was evaluated prospectively to identify and reduce noncardiac medical complications. Medical records were reviewed for in-hospital complications. There were 623 patients in the study cohort and 493 patients in the control population. There was a statistically significant decrease in the incidence of delirium (control, 10.4% vs study, 0.8%; P = .0001), renal (4.9% vs 0.6%, P = .0001), cardiac (16.3% vs 2.1%, P = .0001), and pulmonary complications (5.7% vs 0.8%, P = .0001) in the screened patients vs control. Preoperative screening and management for medical complications resulted in a significant decrease in renal, pulmonary, delirium, and cardiac complications.
本研究旨在验证一种筛选和管理方案，以识别和降低肾、肺和谵妄并发症的风险。对接受全膝关节置换术的连续患者系列与历史对照组进行了队列研究，比较围手术期并发症的发生率。研究队列进行了前瞻性评估，以识别和减少非心脏医学并发症。回顾了住院并发症的医疗记录。研究队列中有 623 例患者，对照组中有 493 例患者。谵妄（对照组为 10.4%，研究组为 0.8%；P=.0001）、肾（对照组为 4.9%，研究组为 0.6%；P=.0001）、心脏（对照组为 16.3%，研究组为 2.1%；P=.0001）和肺并发症（对照组为 5.7%，研究组为 0.8%；P=.0001）的发生率在筛选患者中明显低于对照组。术前对医疗并发症进行筛查和管理，显著降低了肾、肺、谵妄和心脏并发症的发生率。
